Improving treatment protocols of a common birth defect in Vietnam
Cleft lip and palate (CLP) is one of the most prevalent congenital anomalies in the world. This diagnosis is given to one in every 677 live births in Vietnam. As this is a major issue, it requires a comprehensive approach. A Vietnamese doctoral student at the University of Tartu conducted the first study of the treatment outcomes of patients with CLP in his home country to improve deformity-related health behaviour and the organisation and monitoring of treatment. Since there is not enough competence in Vietnam, the locals in need of help are getting aid from organisations and scientists from all over Europe, including Estonia.
In his doctoral thesis, Van Thai Nguyen, a doctoral student at the Faculty of Medicine, states that the average prevalence of CLP worldwide is one diagnosis per 700 live births, so the percentage of children born with this diagnosis in Vietnam is especially high. Children born with CLP need the help of specialists from several fields and their treatment may last from birth to adulthood.
Nguyen noted that many Vietnamese patients hope to get treatment through international charity organisations. The problem is that the teams from charity organisations focus primarily on the surgical closure of the cleft, and they do not have time to provide other treatment methods, such as speech therapy and orthodontic treatment. There are no systematic post-operative follow-ups, and thus, the treatment outcomes of these patients have not been evaluated.
Therefore, the purpose of Nguyen’s doctoral thesis was to evaluate the treatment outcomes of the patients with CLP who have been operated on by doctors from international charity organisations, and based on the conclusions, make suggestions for changing the organisation of health care in Vietnam.
A total of 81 patients with CLP were included in the study. Nguyen evaluated various indicators, such as dental health; nasolabial aesthetics; speech quality; craniofacial morphology: maxillary arch dimensions and upper airway structures; satisfaction of patients and their parents or guardians, and how well mothers are coping after the birth of a child with CLP.
As the main result of his doctoral thesis, Nguyen emphasises the urgent need for establishing a national cleft registry in Vietnam, in order to make it possible to coordinate and monitor the treatment of patients. Also, diagnostic minimum requirements for monitoring patients need to be developed and implemented. “We are going to suggest the organisations organising health care in Vietnam to improve the availability of procedures related to dental health, orthodontic treatment and logopaedic services,” said Nguyen.
According to the supervisor of the doctoral student and an associate professor in orthodontics, Triin Jagomägi, Nguyen is the fourth student from Vietnam to defend a doctoral thesis at the University of Tartu’s Faculty of Medicine. “I am glad that years of cooperation between the University of Tartu and Vietnamese medical universities has yielded a new generation of medical professionals in Vietnam who can use their good knowledge and skills to help improve the health of locals,” said Jagomägi who, in recent years, has been leading the project “Joint capacity building in biomedical higher education through adopting international academic standards and transferring technology between European and Vietnam universities”.
According to Jagomägi, Estonian scientists supported Nguyen by helping him develop research methodology and relate it to the needs of Vietnam. “Estonian patients were also included in the study as a control group. The treatment outcomes of patients treated and monitored according to internationally recognised treatment protocols were compared to those that have been achieved in Vietnam where no other treatment is offered except the surgical closure of the cleft,” said Jagomägi describing the support given to the young Vietnamese colleague by Estonian scientists.
Supervisors of the doctoral thesis “The First Study of the Treatment Outcomes of Patients with Cleft Lip and Palate in Central Vietnam” are Triin Jagomägi, an Associate Professor in Orthodontics at the University of Tartu, and Associate Professor Toai Nguyen from Vietnam.
The translation of this article was funded by the European Regional Development Fund through Estonian Research Council.