The impact of socio-economic factors on parental non-adherence to the Ponseti protocol for clubfoot treatment in low- and middle-income countries: A scoping review.
The impact of socio-economic factors on parental non-adherence to the Ponseti protocol for clubfoot treatment in low- and middle-income countries: A scoping review.
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DOI：
10.1016/j.eclinm.2022.101448
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发表时间：
2022-06
影响因子：
15.1
通讯作者：
中科院分区：
文献类型：
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作者：
Ponseti治疗被认为是全球马蹄内翻足的黄金标准，但需要父母的大力参与。本次审查的目的是评估社会经济因素对低收入和中等收入国家（LMICs）Ponseti治疗期间脱落、复发或不依从的影响。本范围审查包括从开始到2022年4月4日的所有文章。考虑纳入所有描述LMIC中Ponseti治疗期间一个或多个社会经济因素与一个或多个不良结局之间相关性的文章。通过检索Medline/PubMed、Embase、Global Health和Global Index Medicus识别研究。由两名独立审查员使用Covidence extraction 2.0进行数据提取。从数据库检索中共检索到281篇唯一参考文献，保留59篇摘要进行全文审查，其中19项研究纳入最终审查。我们将确定的社会经济因素分为4个较大的主题：贫困和马蹄内翻足诊所的物理可及性，支持系统的存在，父母的教育水平，家庭因素和文化规范。在南亚和加勒比，女孩获得护理的机会减少被认为是一个重要的风险因素。在对东非的研究中，缺乏家庭和社区支持是一个经常提出的问题。在一个小样本的论文中收集的变量之间的极端异质性使得不可能进行荟萃分析。所确定的因素与研究中确定的社会经济因素非常相似，这些研究着眼于父母和儿童在最初寻求护理时面临的障碍。根据这一审查，贫穷被确定为所有四个领域中贯穿各领域的风险因素，也是最重要的社会经济风险因素，再次确认消除贫穷是21世纪世纪的挑战。没有。
The Ponseti treatment is considered the gold standard for clubfoot globally, but requires strong engagement from parents. The aim of this review is to assess the impact of socio-economic factors on the presence of drop-out, relapse or non-compliance during Ponseti treatment in low and middle-income countries (LMICs). This scoping review includes all articles available from inception until 4.4.2022. All articles describing an association between one or more socio-economic factors and one or more adverse outcomes during the Ponseti treatment in an LMICs were considered for inclusion. Studies were identified by searching Medline/PubMed, Embase, Global Health and Global Index Medicus. Data extraction was done using Covidence extraction 2.0 by two independent reviewers. A total of 281 unique references were retrieved from the database searches, 59 abstracts were retained for full-text review, of which 19 studies were included in the final review. We grouped the identified socio-economic factors into 4 larger themes: poverty and physical accessibility of clubfoot clinics, presence of support systems, educational level of the parents, and household-level factors and cultural norms. Reduced access to care for girls was considered an important risk factor in South Asia and the Caribbean. Lack of family and community support was an issue raised more often in studies from Eastern Africa. The extreme heterogeneity among collected variables within a small sample of papers made it not possible to perform a meta-analysis. The identified factors are very similar to the socio-economic factors identified in studies looking at the barriers parents and children face when seeking care initially. Poverty was identified as a cross-cutting risk factor in all 4 domains and the most important socio-economic risk factor based on this review, reconfirming poverty eradication as the challenge for the 21st century. None.
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