A comparative assessment of oral health-related quality of life of children born with orofacial clefts in Sudan and their caregivers'

Abstract

Background Cleft lip and palate(CL/P)is the most common orofacial malformation affecting one in every 700–1000 newborns worldwide. The aim of the study wasto evaluate the impact of CL/P on health- related quality of life (OHRQoL) in Sudanese children and the level of concordance between caregivers' and children and to investigate correlates of the caregivers' perceptions of OHRQoL with that of their children. Methods The sample consisted of 75 children with clefts (age range 8–16 years), (46 male, 29 female) and their caregivers' attending University of Science and Technology Dental Teaching Hospital. The children and their caregivers' were interviewed separately. The interview consisted of 38 questions adopted from the COHIP (Arabic version).The level of concordance between caregivers' and children was compared using paired t-tests and intraclass correlations. Predictive validity was assessed using Pearson correlations and linear regression analyses. Results The translated COHIP and its subscales, had Cronbach' alphas score ranged between (0.65 and 0.75) for caregivers' and children with cleft. COHIP scores for children and caregivers' were (89.41 ± 19.97) and (94.34 ± 19.52) respectively. Caregivers' and children differed significantly in the overall COHIP and oral symptoms subscale. There were high correlations between caregivers' and children ranged from (0.63 to 0.87). The correlation between all subscales was statistically significant (p = 0.05). Conclusions Caregivers' had higher perceptions of oral symptoms and overall COHIP compared to their children using the Arabic version of the COHIP. Caregiver's reports have to be considered complementary to the reports of their children themselves.

Oral-Health-Related Quality of Life among Non-Syndromic School-Age Children with Orofacial Clefts: Results from a Cross-Sectional Study in Northern Italy

“…Cleft children had significantly worse scores than controls for the overall COHIP and its dimensions, with oral health and functional and social-emotional well-being as the most impacted domains. These findings are consistent with those from other studies that applied the COHIP tool [ 23 , 27 , 29 ]. Broder and Wilson-Genderson found in the US that craniofacial patients had significantly lower values for the total COHIP and the functional well-being and school environment domains compared to orthodontic and paediatric patients, while the differences in the social-emotional well-being area were close to statistical significance [ 29 ].…”

“…With regard to the social-emotional well-being subscale, subjects with orofacial cleft were more likely to be anxious or worried about what people think, to feel like they looked different, and to be uncomfortable due to their dissatisfaction with their facial appearance. These findings are in line with those from previous studies [ 27 , 33 ], and they are further supported by the conclusions of a recent systematic review in which speaking, eating, and emotional well-being were found to be the most affected areas of OHRQoL among children and adolescents with CLP [ 9 ].…”

“…Broder and Wilson-Genderson found in the US that craniofacial patients had significantly lower values for the total COHIP and the functional well-being and school environment domains compared to orthodontic and paediatric patients, while the differences in the social-emotional well-being area were close to statistical significance [ 29 ]. Ward et al [ 23 ] observed significantly lower scores for the functional and social-emotional well-being scales in a sample of American CLP children, and Ali et al found that CLP had some adverse impacts on both the overall and subscales of COHIP among a group of Sudanese children [ 27 ]. In contrast, Aravena et al [ 24 ] observed similar OHRQoL among Chilean children with and without orofacial cleft, and Nolte et al [ 25 ] reported relatively high scores among Dutch cleft children comparable to those of parents/caregivers, indicating a good OHRQoL.…”

“…Nonetheless, no clear conclusions can be drawn from the literature. Some studies found lower self-esteem among the CLP population [ 27 , 28 ], while others argued that the patients’ acceptance of their appearance lead to a more favourable self-esteem than unaffected children [ 24 , 35 ].…”

“…Recent systematic reviews identified the Child Oral Health Impact Profile (COHIP) as one of the most valid and reliable instruments among those specifically designed for children and teenagers with orofacial anomalies to measure their own OHRQoL [ 21 , 22 ]. Numerous studies have investigated the influence of CLP on OHRQoL using this survey instrument, and they have reported contradictory findings, as some described low levels of QoL, while others did not show any significant impact [ 23 , 24 , 25 , 26 , 27 ]. Differences in age, ethnicity, sample size, treatment protocols, and study designs may partly account for this discrepancy.…”