The prevalence and factors associated with malnutrition among infants with cleft palate and/or lip at a hospital in Uganda: a cross-sectional study

Abstract

BackgroundTo determine the prevalence and factors associated with malnutrition among infants with Cleft palate and/or cleft lip (CP+/-L) at Comprehensive Rehabilitation for Uganda Hospital (CoRSU) in Uganda.MethodsThis was a cross-sectional study done on infants with CP+/-L and their caretakers admitted between November 2013 and October 2014 at CoRSU hospital which was the study setting. A questionnaire was answered by the infants’ caretakers. The main outcome measure, malnutrition was defined and classified based on Z-scores obtained using the W.H.O Z-calculator in which weights of the infants in kilograms and lengths in centimeters respectively were placed. The values obtained were expressed as a proportion using all enrolled infants with CP+/-L as denominator. Multivariable analysis was used to determine the risk factors.ResultsA total of 44 infants with CP+/-L were enrolled. Of these, 77% were below 4 months of age and 97.7% were immunized. The male-to-female ratio was 1.06:1. About 59% had unilateral CP+/-L. A total of 93.2% were delivered at term with 69.4% having a birth weight greater than 3 kg. Generally, 68% were malnourished, with the highest burden among females (71.4%), infants below 4 months (73.5%) and those with unilateral CP+/-L (77%). About 57% had moderate-to-severe malnutrition. There was delayed supplementation to breast milk, with cow-milk as the main supplemental feed for all the infants. In the multivariable analysis, factors associated with malnutrition included, having caretakers lacking nutritional information post-delivery (OR = 3.8, p = 0.17), low birth weight (OR = 3.4, p = 0.20), and having less than 10 feeds/day (OR = 4.9, p = 0.09).ConclusionCP+/-L infants born in Uganda suffer a high-burden of malnutrition. Preventional strategies are needed with focus on proper feeding information. Research on cost-effective feeds, feeding methods and reasons behind gender disparities in these infants is also required.

Anatomical patterns of cleft lip and palate deformities among neonates in Mekelle, Tigray, Ethiopia; implication of environmental impact

“…The overall prevalence was 3.11 per 1,000 live births indicating a higher figure compared to those obtained in Caucasian populations (approximately 1 per 1000 births) and Asian populations (approximately 1.7 per 1000 births) [10,13]. Nigerian literature reviewed revealed that the prevalence of cleft anomalies was approximately 0.37/1,000 live births, a Ugandan study reported 1.45/1, 000 live births, Tunisia, 1.40/1,000 live births and South Africa, 0.3/1000 live births [14][15][16][17]. In an earlier study conducted at Addis Ababa Ethio-Swedish children's hospital, 8% of children under study were treated for cleft deformities [18] and prevalence of CLP was approximately 1.49/1,000 live births [5].…”

Feeding practices of children aged 0 to 24 months with clefts attending a specialized hospital in Uganda

“…In a 2017 Ugandan study, 50% of children with clefts aged less than 4 months were breastfeeding in contrast to the national exclusive breastfeeding rate of 66% (11,12). This poor feeding practice contributed to the high prevalence of wasting of 74%, which was higher than the 2016 national overall of 8% among children under 6 months of age (11,12). Malnutrition affects cleft repair surgery to improve feeding in this group (13,14).…”

“…Furthermore, published literature on breastfeeding, complementary feeding and techniques among cleft children in Uganda is limited (11,12). This study therefore sought to describe the feeding practices, techniques and maternal knowledge among children with clefts, to recommend interventions that can improve their feeding and reduce their risk of malnutrition.…”

Assisted breastfeeding technique to improve knowledge, attitude, and practices of mothers with cleft lip‐ and palate‐affected infants: A randomized trial

“…There is a need of craniofacial team to assist these mothers for promoting the child's health status who meet periodically to discuss the problems associated with feeding, to monitor growth and development, and for early detection of complications. [1][2][3] To enhance the retention rate of the knowledge, there is a need for repeated, one-on-one education. This is possible with the focused audio-visual educational module that provides both audio as well as visual stimulation for a better understanding of the concept.…”