Trends in Cleft lip and/or Palate Prevalence at Birth in Mexico: A National (Ecological) Study Between 2003 and 2019

OBJECTIVE

To describe trends in cases and prevalence at birth rates of cleft lip and/or palate (CL/P) in Mexico between 2003 and 2019.

DESIGN

Ecological study.

SETTING

Multiple data sources systematically collected into a national epidemiological surveillance data warehouse.

PARTICIPANTS

National Live Birth Information System.

MAIN OUTCOME MEASURE(S)

Both cases and prevalence at birth rates of CL/P in Mexico within a 17-year period were used as dependent variables.

RESULTS

At the national level there were 23 184 new cases of CL/P (average of 1364 per year) in the 32 states of Mexico, with an average prevalence at birth rate of 0.53 per 1000 live births. The states with the highest prevalence at birth rates of CL/P during the period were Hidalgo (1.59) and Jalisco (1.32), while the states with the lowest rates were Nayarit (0.22) and Durango (0.29). A slight decrease in both cases (z = -2.41, P = .016) and prevalence at birth rates (z = -2.58, P = .010) of CL/P was observed at the national level. States such as Durango, Puebla, Chiapas, Guerrero, Oaxaca, Mexico City, State of Mexico, Coahuila and Jalisco showed a clear downward trend (P < .05) in their prevalence at birth of CL/P between 2003 and 2019, while in Hidalgo its trend was upward (P = .05). Significant differences by sex and region were observed (P < .05).

CONCLUSION

Some states consistently had the highest or lowest prevalence of CL/P. Decreasing trends in the overall prevalence at birth rates were observed. More detailed, epidemiological studies are necessary to adequately characterize CL/P in the Mexican population.

Reported prevalence of von Willebrand disease worldwide in relation to income classification

INTRODUCTION

The diagnosis of von Willebrand disease (VWD) is complex and challenging, especially when diagnostic resources are limited. This results in a lack of consistency in identifying and reporting the number of people with VWD and variations in the VWD prevalence worldwide.

AIM

To analyze the reported prevalence of VWD worldwide in relation to income classification.

METHODS

Data on the VWD prevalence from the World Federation of Hemophilia Annual Global Survey, national registries of Australia, Canada, and the United Kingdom, and the literature were analysed. The income level of each country was classified according to the World Bank.

RESULTS

The mean VWD prevalence worldwide was 25.6 per million people. The VWD prevalence for high-income countries (HIC) of 60.3 per million people was significantly greater (p < .01) than upper middle (12.6), lower middle (2.5) and low (1.1) income countries. The type 3 VWD prevalence for HIC of 3.3 per million people was significantly greater (p < .01) than lower middle (1.3) and low income (0.7) countries. The reported VWD prevalence was greater among females than males.

CONCLUSION

The reported VWD prevalence varied considerably across and within income classifications. The variability of type 3 VWD prevalence was less than the VWD prevalence (all types). The variability in detection and diagnosis of type 1 VWD presents a challenge in forming a consistent prevalence value across countries and income classifications.