Orofacial Clefts: A Clinical Community Study in a Developing Country

Abstract

Aim. The study aimed at finding the types of orofacial clefts, reasons for delay in the repair of the deformity and medium through which patients and/or their relatives heard about the outreach program. Methods. This study was from 2009 to 2011 at two different study sites. The team visited various media houses and health facilities at each study site to disseminate information concerning the cleft outreach program. Patients and/or their parents who visited the hospitals were interviewed using a questionnaire designed for the study to retrieve needed information for the study. Patients were then examined and booked for cleft repair by specialists in the team. Results. A total of 61 patients were recorded from both study sites, with ages ranging from 3/12 to 54 years old, with a mean age of 6.7±2.7 (SD) years; while, male : female ratio was 1.05 : 0.5. Cleft lip only (52.5%, n=32) was the highest type of orofacial cleft recorded in the study. In terms of occurrence, complete cleft (63.9%, n=39) was majority; while, position-wise, unilateral cleft right (32.8%, n=20) was the highest. A significant (P=0.017) association between males and unilateral right cleft lips was identified. Lack of finance (47.5%, n=29) was the main reason for delaying in deformity repair. Also, information from physician (41.0%, n=25) was the major medium for information dissemination. Conclusion. Unilateral cleft lip constitutes most of the orofacial clefts in this study, with lack of finance being the commonest reason why patients delay in the repair of their deformity.

The Tale of the Unrepaired Cleft—Retrospective Evaluation of Cases Encountered by an Indigenous Mission in a Northern Nigerian Community

“…Regarding the common reason for the delay in presenting for surgical intervention, most of our patients cited their inability to offset the cost of cleft surgery as the primary factor protracting their care seeking. The proportion of these participants is similar to the observations of Adeyemo et al (2009) in Nigeria and Agbenorku et al (2013) in Ghana, where 47.5% and 56.7% of their patient population alluded to the lack of finance as the main reason for late presentation. Collectively, this observation reflects the effect of the socioeconomic state of these developing countries especially within sub-Saharan Africa on the cleft-care seeking behavior of patients or their caregivers and the endemic nature of "lack of finance" as a barrier to surgical repair.…”

“…Further, our findings buttress the report of Ajike et al (2013), who reported a similar experience with 41.8% of their cases indicating "family and relatives" as their source of information. Studies by Agbenorku et al (2013) and Aziz et al (2009) however recorded contrasting findings in that the former, in a study conducted in rural Ghana, reported "hospital referral" (32.8%) as the commonest source of information indicated by their participants, while Aziz et al (2009) reported that majority of their study participants were recruited through adverts posted on print media platforms. Although this appears to be dependent on the characteristics of the target population, we recommend the adoption of low-cost, person-contact information dissemination methods for community penetrance in future surgical missions.…”

“…Unfortunately, these guidelines are a far cry from what is obtained in developing countries, especially in sub-Saharan Africa, where in comparison to the prevalence of the congenital anomaly, substantial cases of unrepaired clefts are still being reported. This situation has been ascribed to the poor socioeconomic state of these countries, lack of adequate awareness on the condition, dilapidated health care facilities, and remoteness of standardized surgical care for cleft lip and palate anomalies (Agbenorku et al, 2013;Ajike et al, 2013). The advent of surgical missions, majority of which have been carried out by volunteer organizations from developed countries, have brought about an encounter-based phenomenon wherein adult clefts have been duly identified and treated surgically (Obuekwe and Akpata, 2004;Aziz et al, 2009;Ajike et al, 2013).…”

Expectations of Caregivers of Patients with Cleft Lip and Palate Attending the Cleft Clinic of KATH for the First Time

“…of what to expect at the cleft clinic agreed with a study in developing countries, where factors such as cultural beliefs, superstitions, lack of awareness of treatment services, and lack of time have been reported to contribute to delayed presentation of CL ± P patients[23] [24].…”