Prevalence of Congenital Talipes Equinovarus in Sub-Saharan Africa: A systematic review and meta-analyses

Clubfoot has been identified as one of the common congenital malformations that experience an immense physical, social, and economic load throughout the life course. Children with club foot fail to obtain access to education and have other social achievements slower than their healthy peers, which may eventually lead to significant poverty. Majority of clubfoot cases are being born in Low- and Middle-income Countries. Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence of congenital talipes equinovarus/club foot, from Medline (PubMed), Cochrane Library, HINARI, Google Scholar and grey literatures. A weighted inverse variance random-effects model was used to estimate the pooled prevalence of congenital equinovarus. A total of 2181 studies were identified; 1006 from Pub Med, 118 from Cochrane Library, 960 from Google Scholar and 97 from other sources. After duplication removed, a total of 881 articles remained. Finally, 140 full-text studies were reviewed and 23 articles were met the inclusion criteria selected for this systematic review and meta-analysis with 420,234 total enrolled births and 6,051 births with congenital anomaly. The pooled prevalence of congenital talipes equinovarus among births with congenital anomaly in Sub-Saharan Africa is found to be 13.41% (95% CI;8.96-17.87; I 2 =97.3%; p<0.001). Based on the current review, it can be concluded that, the pooled prevalence of congenital talipes equinovarus is lower in Sub-Saharan Africa compared to reports in developed countries; however, it is higher compared to results from developing countries. Therefore, Special attention and efforts should be applied for institution of club foot surveillance and management center with affordable costfor better prognosis of all forms of congenital talipes equinovarus (CTEV) to reduce the burden in Sub-Saharan Africa.