Descriptive Epidemiology of Orofacial Clefts in Ethiopia

Eshete, Mekonen; Butali, Azeez; Deressa, Wakgari; Pagan-Rivera, Keyla; Hailu, Tsegaye; Abate, Fikre; Mohammed, Ibrahim; Demissie, Yohannes; Hailu, Abiye; Dawson, Deborah V.; Deribew, Milliard; Gessese, Mulualem; Mossey, Peter

doi:10.1097/scs.0000000000003234

Cited by 17 publications

(11 citation statements)

References 13 publications

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“…This prevalence rate could be underestimated, because it excludes stillbirths, abortions and those children who might have died within the first three months of birth, or before seeking care. Nonetheless, this rate is also comparable to those found in Nigeria of 0.5 per 1000 live births [39] and higher than that of Ethiopia at 0.2 per 1000 live births [38]. In contrast, the prevalence rate reported in our study is lower than the rates reported for a population base birth defects registries from 30 countries from 54 international craniofacial registries during the period 2000 to 2005, where the overall prevalence of CLP was 1.0 per 1000 [51].…”

Section: Discussionsupporting

confidence: 82%

“…In many African countries, active population based surveillance systems are not available. Prevalence is estimated from hospital-based data, and ranges from 0.2/1000 live births in Ethiopia [38], 0.5/1000 in Nigeria [39], 0.8/1000 in Uganda [22] and 1.7/1000 reported in Kenya [40]. A community household survey in South East Ghana found an estimated prevalence of 6.3/1000 people with CLP [41], however CLP was measured through community self-reporting rather than clinical examination.…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa

Hlongwa

Rispel

2019

PLoS ONE

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Objective The study was conducted to determine the epidemiology and clinical profile of individuals with cleft lip and/or palate (CLP) utilizing specialized academic treatment centres in South Africa’s public health sector. Materials and methods The Human Research Ethics Committee of the University of the Witwatersrand in Johannesburg provided ethical approval for the study. We conducted a retrospective record review of all cases of CLP treated at the specialised academic centres for the two-year period from 1 January 2013 until 31 December 2014. We used a structured, pre-tested record review form to obtain demographic, clinical and treatment information on each CLP case. We used Stata 13 to analyse the data and conducted statistical tests at 5% significance level. Results We analysed 699 records of individuals with CLP. The estimated prevalence of CLP in the South African public health sector was 0.3 per 1000 live births, with provincial variation of 0.1/1000 to 1.2/1000. The distribution of clefts was: 35.3% cleft palate; 34.6% cleft lip and palate; 19.0% cleft lip and other cleft anomalies at 2%. Of the total number of CLP, 47.5% were male and 52.5% female, and this difference was statistically significant (p<0.001). The majority of clefts occurred on the left for males (35.5%) and palate for females (43.4%), with a male predominance of unilateral cleft lip and palate (53.3%). Conclusion The study findings should inform the implementation of South Africa’s planned birth defect surveillance system and health service planning for individuals with CLP.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa

Hlongwa

Rispel

2019

PLoS ONE

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“…[ 8 9 ] Other studies also show similar gender distribution patterns. [ 10 11 12 13 14 15 ] CLA was the most common diagnosis made which concur with previous local studies which also showed a similar trend. [ 15 16 ] Other authors have however reported CL and palate to be more prevalent in their centers.…”

Section: Discussionsupporting

confidence: 88%

Management of orofacial cleft in Nigeria - A retrospective study

James

Adekunle

Adamson

et al. 2020

Ann Maxillofac Surg

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Introduction: Orofacial clefts (OFCs) are among the most common craniofacial developmental abnormalities worldwide and a significant cause of childhood morbidity and mortality. This study aimed to identify patterns of patient presentation, treatment approaches, and changes in our overall cleft care service between 2007 and 2019. Methods and Methodology: A retrospective review of patients managed at a tertiary health facility in Nigeria of all OFC cases operated between 2007 and 2019 was done using the postintervention data retrieved from the Smile Train database. Data of all OFC cases operated within the period were analyzed using the Statistical Package for the Social Sciences. Descriptive statistics were performed using the Statistical Package for the Social Sciences version 20.0. Results: A total number of 740 OFC surgeries were performed in 565 patients, consisting of 269 females (48.2%) and 289 males (51.8%). The majority (63%) of the patients presented before the age of 2 years. Thirty-seven percent presented with cleft lip and alveolus, 27.1% with cleft palate only, and 36.7% with cleft lip, alveolus, and palate. Primary cleft lip repair was the most performed surgery (n = 320, 43.2%), the mean age at repair was 2.1 years. Since 2017, additional services such as speech therapy, mixed dentition orthodontics, and nutritional support were added to services provided to our cleft patients. Fifteen patients have undergone speech assessment and three have completed speech treatment. Eight patients have undergone mixed dentition stage orthodontic treatment. Discussion: Our services have evolved from simply providing surgical care to comprehensive care with a multidisciplinary team approach and provision of a wide range of services including nutritional counseling, pediatric care, orthodontic services, and speech therapy. We believe these will improve the overall well-being of our patients while we continue to improve on services based on clinical research outcomes.

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“…This delayed age of consultation has also been reported in other LMICs. [49][50][51] Lip surgery provides comfort to the parents of CLP children, as they are able to show their children in public and avoid stigmatisation. Strategies need to be developed to ensure that the majority of children with CLP have access to lip surgery within the first 6 months of life.…”

Section: Researchmentioning

confidence: 99%

Comparative analysis of healthcare provision to individuals with cleft lip and/or palate at specialised academic centres in South Africa

2019

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Cleft lip and/or palate (CLP) is the most common congenital anomaly of the craniofacial complex, with an estimated worldwide prevalence of 1/500-700 live births. [1] In South Africa (SA), CLP is among the 5 most common birth defects reported, [2] with an estimated prevalence of 0.1-0.4/1 000 live births. [2-4] Affected children present with a number of medical problems and potential complications that include feeding difficulties, hearing loss, speech problems, disfigured appearance and dental malformation. [5-8] Hence, individuals with CLP require coordinated and specialised treatment offered by a multidisciplinary team, [9-11] which includes geneticists, maxillofacial surgeons, otolaryngologists, orthodontists, paediatricians, plastic surgeons, paediatric dentists, psychologists, professional nurses, social workers and speech and language therapists. [12-14] These teams are available in high-income countries (HICs). Various clinical protocols have been proposed for the treatment of CLP. [15] Many HICs have adopted national protocols and guidelines and have centralised services and/or established centres for the management and follow-up of affected individuals. [16-19] The advantages of centralisation and/or concentration of specialised services include the following: coordination of treatment, standardised data collection, availability of a critical mass of experts, clinical audit and review to enhance quality of care, responsiveness to patient and family needs, and ongoing monitoring and evaluation. [12,20-26] Globally, it is estimated that only 20% of individuals with CLP have access to comprehensive treatment that involves a team coordinated approach. [27] The treatment and care gaps include: lack or shortages of healthcare professionals, lack of infrastructure and delays in surgical repair of the clefts. [27,28] These gaps are most pronounced in low-and middle-income countries (LMICs) in Africa, Asia and South America. [28,29] In many LMICs, outreach programmes by nongovernmental organisations (NGOs) have assisted in improving the services for individuals with CLP. [29-34] These NGOs, together with support groups that include parents of the affected children, have played an important role in the ongoing management of CLP patients. However, the majority of LMICs, including SA, lag behind in terms of national treatment protocols, standardised data collection, access to care by a multidisciplinary team, and evaluation of treatment outcomes. [12,18,35] Notwithstanding improvements in the treatment of CLP individuals in the preceding decades, [36-38] there is still no universal protocol for repair and ongoing clinical management. However, treatment modalities in the management of CLP are often based on chronological age and dentofacial development. [38] The common elements of clinical standards and sequence of treatment of CLP are shown in Table 1. [38] At birth, genetic counselling is given to parents, and feeding of the baby is evaluated. Depending on the size of the cleft, feeding plates are recommended withi...

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Descriptive Epidemiology of Orofacial Clefts in Ethiopia

Abstract: Background-The prevalence of birth defects including orofacial clefts (OFC) in Ethiopia is not known and there is no established birth defects registration system.

Cited by 17 publications

References 13 publications

Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa

Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa

Management of orofacial cleft in Nigeria - A retrospective study

Comparative analysis of healthcare provision to individuals with cleft lip and/or palate at specialised academic centres in South Africa

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