Assessment of awareness and barriers to clubfoot treatment in the Indian scenario

BACKGROUND: We undertook this study to evaluate the awareness of the Primary Caregivers of children with clubfoot aka Congenital Talipes Equino Varus (CTEV) and their familiarity with the disease, their beliefs, knowledge and compliance to treatment, and barriers encountered during the treatment process. SETTINGS AND DESIGN: Cross-sectional, analytical study. MATERIALS AND METHODS: A standard questionnaire in the local vernacular language was prepared, on which 108 respondents were interviewed. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) software program, version 21.0. Chi-square test was applied wherever suitable as a parametric test. RESULTS: Approximately 57.40% of participants had no prior knowledge of clubfoot at all, till they had a child born of the deformity in the family. Superstitions like lunar eclipse (37.96%), punishment from God (37.03%), solar eclipse (34.26%) and black magic (26.85%) were widely prevalent as the perceived cause of the deformity. Only 25% of the participants believed that any kind of treatment should be started immediately after birth and 20.37% of the study population felt the first line of treatment should be a visit to a spiritual healer or to a shrine of a saint. Approximately 68.52% of the study participants were satisfied with the explanation of the disease process and treatment plan offered by the treating doctor. Approximately 52.77% perceived social stigma as an obstacle to treatment, whereas 58.33% had difficulties adjusting to change of home or workplace routines. CONCLUSION: The awareness level regarding clubfoot in the primary caregivers in the Indian scenario is low and has an implication on successful treatment and compliance.