A.I. Michael1, A.A. Olusanya2, O.A. Olawoye1, S.A. Ademola1, A.O. Iyun1, V.I. Akinmoladun2 and O.M. Oluwatosin1
- Department of Surgery, College of Medicine, University of Ibadan and Department of Plastic Reconstructive and Aesthetic Surgery, University College Hospital, Ibadan.
- Department of Oral and Maxillofacial Surgery. Faculty of Dentistry. College of Medicine. University of Ibadan.
Background: The UCH/Smile Train partnership, which offers free cleft surgeries to patients provides succor.
Objective: The objective of the study was to determine the state distribution of new patients presenting with cleft lip and palate, to The UCH.
Method: A retrospective review of all new cleft patients presenting to The UCH between January 2012 and June 2015. The data obtained were their local government area of residence, age of the patients, gender of the patients and the type of cleft. Descriptive statistics was used to analyze the distribution of patients seen while Chi square test was used to analyze the influence of gender and laterality on the type of cleft.
Results: Sixty-seven eligible patients were seen within the study period. Majority (83.6%) of patients seen were from 14 of the 33 Local Government Areas (LGA’s) in Oyo state. Patients were seen from LGA’s in proximity to UCH. A few (16.4%) of the patients came from outside the state. Iwajowa, the LGA with the least number of patients (1.8%) was furthest from UCH. Left sided clefts were significantly more than bilateral or right-sided clefts (p=0.001). Most of the patients from Oluyole LGA had CP while no patient with CP was seen from Lagelu and Akinyele LGA’s.
Conclusion: There is the need to intensify cleft awareness programs. Further studies into the health habits, cultural beliefs and genetic profile of communities may explain some regional distribution of cleft types seen.
Dr. A.I. Michael
Department of Plastic Reconstructive
and Aesthetic Surgery,
University College Hospital,
There are an estimated 800,000 untreated cases of clefts in Africa every year.1 This means 800,000 children with the likelihood of isolation, rejection from their disfigurement, reduction in their quality of life and sub optimal productivity in the society.1,2 The scourge of this deformity is seen more among the low socioeconomic groups.3,4 Financial constraints and ignorance limits the likelihood of presentation to centers for proper management. In a study in Lagos most of the patients presented with cleft lip and palate were delivered in maternity homes, with only 22% of cases were delivered in general or teaching hospitals.2 Smile Train is the world largest charity for clefts with a goal to make free, safe and quality treatment of cleft lip and palate available to those who cannot afford it.1 They are in partnership with both government and non-government owned hospitals worldwide. University College Hospital, Ibadan (UCH) is a Federal government owned tertiary care facility in South West Nigeria with a bed capacity of 850.5 It is located in Ibadan North Local Government Area, Oyo State (Oyo State Government (2016). Oyo State is located in the southwestern geopolitical zone of Nigeria. It has a land mass of approximately 27,249 square kilometers and a population of approximately five million. It is divided into 33 Local Government Areas (LGA’s). The major ethnic group is Yoruba. The state has both urban and rural settlements.6 The UCH has been in partnership with Smile Train since 2007. It is the only Smile Train government owned partner in the state. It has effectively carried out two awareness programs (in the years 2008 and 2012) on the availability of this free service in Ibadan North and Ibadan South West local government areas. The awareness programs consisted of radio jingles, television health talks, distribution of hand fliers and posters as well as community meetings. Resource constraints had prevented the continuation of awareness programs. There had been no awareness programs within the period of the study. The aims of the study were to identify the regional distribution of new patients presenting with cleft lip and palate, to determine any peculiarities of cleft epidemiology from the regions represented, to assess the impact of UCH on this distribution and make recommendations for subsequent awareness programs.
PATIENTS AND METHODS
It was a retrospective review of new patients with cleft of primary palate (CL), cleft of the secondary palate (CP) and cleft of both the primary and secondary palate (CLP) presenting to the outpatient cleft clinic of the University College Hospital between January 2012 and June 2015. Informed consent was obtained for all patients recruited under the Smile Train grant and approved by the institution. Patients data were entered into the Smile Train/institutional approved proforma. The data obtained were their addresses, age of the patients, gender of the patients and the type of cleft. The local government areas of residence were identified from the addresses. The study complied strictly with the Helsinki declaration on research involving human subjects. Statistical analysis was done using frequencies and Chi square tests to analyze the influence of gender and laterality on the type of cleft.