Incidence and patterns of congenital talipes equinovarus (Clubfoot) deformity at Queen Elizabeth Central Hospital, Banter, Malawi

Abstract

Background: Clubfoot is one of the most common externally visible congenital deformities recorded in Sub Saharan Africa. The main objective of this study was to assess the overall incidence of clubfoot deformity in neonates born at Queen Elizabeth Central Hospital (QECH) in Malawi.

Methods: A prospective study of all congenital anomalies presenting at the neonatal unit of QECH was started on 1^st November 2000. All neonates with congenital anomalies born at or referred to QECH were enrolled in the study. The patterns of clubfoot with respect to gender, side of deformity, association with other congenital anomalies, maternal demographic characteristics and maternal obstetric history were recorded.

Results: The total number of births at QECH during the study period was 16877. The number of children with clubfoot deformity recorded was 64 or 1 in 496 births, translating to 2 per 1000 births at QECH. The male to female sex ratio was 1.3:1. One child was a true hermaphrodite. Forty-seven (73%) of the children had bilateral clubfeet. Among the 17 children with a unilateral club foot the right side was involved in 12 (71%) of the children. Twenty-two (34.4%) of children had other associated congenital anomalies or a syndrome diagnosis. Neurotube defects were the commonest anomalies associated with clubfeet.

Recommendation: The study should be continued and expanded to other hospitals and also to traditional birth attendants in order to establish the true incidence of clubfoot in Malawi.