RESUMEN
OBJECTIVE: To estimate the number of new cases of cleft lip and cleft palate in the department (state) of Alta Verapaz, Guatemala, in 2012. DESIGN: Cross-sectional survey of midwives from communities identified through a two-stage cluster-sampling process. Midwives were asked how many babies they had delivered in the past year and how many of those newborns had various types of birth defects, as illustrated in pictures. SETTING: Indigenous Mayan communities in rural north-central Guatemala. PARTICIPANTS: Midwives (n = 129) who had delivered babies in the previous year. MAIN OUTCOME MEASURE: Reports of babies born with cleft lip and cleft palate. RESULTS: A 1-year prevalence rate of 18.9 per 10,000 for cleft lip and 4.7 per 10,000 for cleft palate was estimated for Alta Verapaz. None of the cases of cleft lip also had cleft palate. CONCLUSION: The indigenous communities in north-central Guatemala might have a relatively high cleft lip prevalence rate compared with the global average.
Asunto(s)
Labio Leporino/epidemiología , Fisura del Paladar/epidemiología , Estudios Transversales , Femenino , Guatemala/epidemiología , Humanos , Indígenas Norteamericanos , Recién Nacido , Masculino , Prevalencia , Población RuralRESUMEN
This paper uses road network analysis to quantify access to health care services in Alta Verapaz, a rural district in Guatemala with a majority Mayan population. Population data from the 2002 Guatemalan census, the location of health care facilities from the Ministry of Public Health and Social Assistance, and road and trail locations from the National Geographic Institute were included in a geographic information system (GIS). We computed the shortest path from each populated place to the nearest health care facility and then estimated the approximate travel time to the health facility based on road surface type. Road network analysis found that approximately 38.1% of residents of Alta Verapaz live within one hour of a hospital and 76.8% live within one hour of a basic care facility. In comparison, a circular buffer method found that 27.5% had access to a hospital and 94.5% had access to a primary care facility. Poverty was correlated with reduced access to care. The use of models that adjust for road types and allow for accurate estimation of travel times are helpful tools to identifying populations with limited access to health care services.