Orofacial Cleft in Rwanda: a Scoping Review of Empirical Evidence

Abstract

Background Orofacial clefts (OFCs) are among the most common congenital anomalies accounting for over 4.6 million cases. OFCs are associated with significant morbidity and a heightened risk of infant mortality in many developing nations due to barriers to accessing multidisciplinary care. Rwanda has a considerable burden of OFCs. This scoping review aims to identify knowledge gaps, establish research agendas, and inform decision-making for policy redirection in Rwanda regarding OFCs. Methods The design and reportage of this scoping review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Following the search of eleven electronic databases, all retrieved articles were imported into the Rayyan web application where deduplication of the duplicate literature was done. One hundred and fourteen articles were obtained from the literature search. After screening and deduplication, only 8 articles were included in the scoping review for data charting, collation, and summarization. Results Rwanda faces a significant burden of OFCs according to the reported OFCs prevalence range (12.1–34.2%) reported across all Rwanda provinces. In addition, only 6 general medicine surgeons were supporting to repair OFCs as part of their internship short training in Rwanda. The prevalence and distribution of OFCs vary across different demographics and age groups, with males having a higher prevalence than females. This review also reported on the clinical care of OFCs in Rwanda, highlighting low retention of care among OFC patients. Conclusion Overall, the review findings highlight the need for targeted interventions, including early detection of associated anomalies, improved prenatal care, and access to specialized care facilities for infants born with cleft lip and/or palate, especially those with associated malformations. There is a need for policymakers and other stakeholders to ensure strategies to increase the number of specialists who can support people with OFCs and ensure high retention of care among OFCs in Rwanda. Further, OFCs-related studies with representative sample sizes and advanced research designs are needed in Rwanda to bridge the gap on OFCs' limited information and to better inform the Rwandan Health policy on OFCs.