Abstract
This study examines the spatial structure of children with cleft lip and palate (CLP) and its association with polluted areas in the Monterrey Metropolitan Area (MMA). The Nearest Neighbor Index (NNI) and the Spatial Statistical Scan (SaTScan) determined that the CLP cases are agglomerated in spatial clusters distributed in different areas of the city, some of them grouping up to 12 cases of CLP in a radius of 1.2 km. The application of the interpolation by empirical Bayesian kriging (EBK) and the inverse distance weighted (IDW) method showed that 95% of the cases have a spatial interaction with values of particulate matter (PM10) of more than 50 points. The study also shows that 83% of the cases interacted with around 2000 annual tons of greenhouse gases. This study may contribute to other investigations applying techniques for the identification of environmental and genetic factors possibly associated with congenital malformations and for determining the influence of contaminating substances in the incidence of these diseases, particularly CLP.
Highlights
Cleft lip and palate (CLP) is a congenital anomaly that affects the facial structure
We found that cleft lip and palate (CLP) cases do not present a random distribution, measured with Nearest Neighbor Index (NNI) and Nearest Neighbor Hierarchical Clustering (NNHC) techniques
Our study reviewed the spatial distribution of children with CLP and its association to environmental pollutants in Monterrey Metropolitan Area (MMA), which is one of the most polluted regions in Latin America
Summary
Cleft lip and palate (CLP) is a congenital anomaly that affects the facial structure. CLP is the more prevalent congenital craniofacial anomaly worldwide, affecting between 0.7–1.5/1000 newly live births. The prevalence of CLP in Mexico has been estimated in 0.6 to 0.9/1000 births [1]. The CLP has important implications for the patient and his family, including swallowing and language development. This disorder causes psychological and social afflictions, such as discrimination, low self-esteem and difficulty to interact in society [2], as well as economic implications in terms of health care, plastic surgery, and rehabilitation. The Global Burden of Disease for CLP in 2016 was calculated at 3.4/100,000 disability-adjusted life years (DALYs) with 95% uncertainty intervals of 2.1 to 5.3 [3]
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