Prevalence of Orofacial Clefts in Nigeria

Abstract

Orofacial clefts (OFC) are the most common malformations of the head and neck. In Africa, OFC is under-ascertained with little or no surveillance system in most parts for clefts and other birth defects. A Nigerian craniofacial anomalies study “NigeriaCRAN” was established in 2006 to support cleft research specifically for epidemiological studies, treatment outcomes and; studies into etiology and prevention. We pooled data from seven of the largest Smile Train treatment centers in the six geopolitical zones in Nigeria. Data from September 2006 to June 2011 were analyzed and clefts compared between sides and gender using the Fisher’s exact test. A total of 2197 cases were identified during the study period with an estimated prevalence rate of 0.5/1000. Of the total number of OFC, 53.3% are males and 47%.7 are females. There was a significant difference (p=0.0001) between unilateral left clefts and unilateral right clefts and; significant difference (p=0.0001) between bilateral clefts and either clefts on the left or right side. A significant gender difference (p=0.03) with more females than males was also observed for CP. A total of 103 (4.7 %) associated anomalies were identified, nine syndromic cleft cases and 10.4 % of the total number of clefts individuals have an affected relative. The significant difference between unilateral clefts and gender differences in the proportion of cleft palate only are consistent with the literature. The present study emphasizes the need for birth defects registries in developing countries in order to estimate the exact prevalence of birth defects including OFC.

Descriptive Epidemiology of Orofacial Clefts in Ethiopia

“…The distribution of the cleft types which is done for all operated cleft patients (18073) during the study period is: cleft lip only (CLO = 12831, cleft lip and palate (CLP=4632), and cleft palate only (CPO = 541). The number of isolated cleft palate in this study (3%) is low similar to other African studies (15, 16,11), It is also more common in males similar to the study done by Conway et al (16). …”

“…Iregbulem (1982) reported a prevalence of 0.3/1000 in the Eastern part of Nigeria (10). Butali et al (2014) reported a countrywide prevalence of 0.5/1000 (11). The incidence and prevalence of these anomalies in Ethiopia are not known and there are only two published reports about these anomalies.…”

Congenital malformations and medical conditions associated with orofacial clefts in children in Burkina Faso

“…Indeed, we found a higher frequency of associated congenital malformations, whereas African studies found lower frequencies between 4 and10.5% [18, 19]. Our result, however, was lower than in some reports from the Middle East and Asia where [20] found a frequency of 43.3% in Jordan, [2] reported 14.8% in India; [3, 4] reported 17.8 and 21.6% in Iran, respectively.…”

Genetic factors influencing risk to orofacial clefts: today’s challenges and tomorrow’s opportunities

“…The worldwide average birth prevalence of all orofacial clefts is 9.92 per 10,000 (close to one per 1,000), but there is substantial variation among populations 7 . In general, East Asian and Native American populations have substantially higher birth prevalence rates than do European and South Asian populations, while African ancestry populations have lower birth prevalence rates 8– 10 .…”