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Ács L, Nemes B, Nagy K, Ács M, Bánhidy F, Rózsa N. Maternal factors in the origin of cleft lip/cleft palate: A population-based case-control study. Orthod Craniofac Res 2024; 27 Suppl 1:6-13. [PMID: 38010849 DOI: 10.1111/ocr.12738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES Orofacial clefts are among the most common birth defects, with an estimated worldwide incidence of around 1.5-1.7 per 1000 live-born babies. The most frequent form of orofacial clefts is cleft lip with or without cleft palate (CL ± CP). The role of environmental factors in the development of clefts is unclear in most patients, thus the aim of this study was to estimate possible maternal risk factors in the origin of CL ± CP. MATERIALS AND METHODS 1648 CL ± CP cases, 2654 matched controls and 57 231 population controls were evaluated from The Hungarian Case-Control Surveillance of Congenital Abnormalities. Maternal factors during the critical period in cases and controls were compared. Adjusted odds ratios (OR) with 95% confidence intervals (CI) were estimated in a multivariable conditional logistic regression model. RESULTS Among socio-demographic data, we have found significant differences between maternal employment. The proportion of unskilled mothers (6.5%) were higher in the CL ± CP group than in controls (3.5%). Medically recorded maternal anaemia, excessive vomiting and threatened abortion were associated with a higher risk of CL ± CP. An elevated risk was also found in various acute illnesses such as influenza (OR: 2.4, 95% CI: 3.0-5.8), acute bronchitis (OR: 4.5, 95% CI: 1.6-12.6) and urinary tract infections (OR: 3.5, 95% CI: 2.0-6.0). Maternal migraine and essential hypertension occurred more frequently in the mothers of cases than in controls. CONCLUSION The findings of this study suggest that maternal diseases and lifestyle factors during the first trimester play a significant role in the development of CL ± CP.
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Affiliation(s)
- Lili Ács
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University Faculty of Dentistry, Budapest, Hungary
| | - Bálint Nemes
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University Faculty of Dentistry, Budapest, Hungary
| | - Krisztián Nagy
- Department of Paediatrics, Semmelweis University School of Medicine, Budapest, Hungary
- OMFS-IMPATH KU Research Group, Leuven, Belgium
| | - Márton Ács
- Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University Faculty of Dentistry, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Ferenc Bánhidy
- Department of Obstetrics and Gynaecology, Semmelweis University School of Medicine, Budapest, Hungary
| | - Noémi Rózsa
- Department of Paediatric Dentistry and Orthodontics, Semmelweis University Faculty of Dentistry, Budapest, Hungary
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Taiwo AO, Lehmann U, Scott V, Shafi'u I, Lawal SG, Abdulmajid U, Braimah RO, Ibikunle AA, Abubakar AB, Mujtaba B, Ogbeide ME, Labbo-Jadadi S, Adigun OI, Ile-Ogedengbe BO. Barriers in Cleft Service Access in Sub-Saharan Africa: A Thematic Analysis of Practical Needs of Rural Families. Cleft Palate Craniofac J 2024:10556656241244976. [PMID: 38557293 DOI: 10.1177/10556656241244976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE To explore the experiences and perceptions of barriers of parents and family members of patients with cleft lip and palate in accessing cleft services in remote northwest Nigeria. DESIGN Face-to-face semi-structured audio recorded interviews were used to obtained qualitative textual data. Thematic analysis using interpretative descriptive techniques was employed to understand the participants' lived experiences with barriers and accessibility to cleft services. SETTING Participants were from Sokoto, Kebbi and Zamfara states in remote northwest, Nigeria. PARTICIPANTS Consisted of 22 caregivers (17 parents and 5 extended family members) were purposively sampled between 2017 and 2020. MAIN OUTCOME MEASURES Barriers experienced while accessing cleft services were identified during thematic analysis. RESULT Over three quarter of the respondents had patients with both cleft lip and palate and without any previous family history (n = 20). About two-thirds of the participants (n = 15) were females. Most of the interviews were conducted before the surgeries (n = 15). FIVE THEMES EMERGED lack of information, financial difficulty, misrepresentation from health workers, multiple transportation and previous disappointment. CONCLUSIONS Areas of poor awareness, misinformation from primary health care workers, financial hurdles, multiple transportation logistics and others were identified. Aggressive broadcasting of information through radio, timely treatment and collaboration with influential religious leaders were emphasized. Support, grants and subsidies from government and voluntary agencies are encouraged to mitigate the huge out of pocket cost of cleft care in the region.
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Affiliation(s)
- Abdurrazaq Olanrewaju Taiwo
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
- Resmile Craniofacial Anomaly Foundation Zamfara, Gusau, Zamfara, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Health Science, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Uta Lehmann
- School of Public Health, University of Western Cape, Cape town, South Africa
| | - Vera Scott
- School of Public Health, University of Western Cape, Cape town, South Africa
| | | | - Suleman Gusau Lawal
- Department of Family Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Usamatu Abdulmajid
- Department of Otolaryngology/ENT, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Ramat Oyebummi Braimah
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Health Science, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Adebayo Aremu Ibikunle
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | - Bala Mujtaba
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, College of Health Science, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Mike Eghosa Ogbeide
- Department of Dental and Maxillofacial Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Suwaiba Labbo-Jadadi
- Department of Dental and Maxillofacial Surgery, Sir Yahyah Memorial Hospital, Birnin-Kebbi, Kebbi, Nigeria
| | - Olufemi Ibrahim Adigun
- Resmile Craniofacial Anomaly Foundation Zamfara, Gusau, Zamfara, Nigeria
- Department of Dental and Maxillofacial Surgery, Federal Medical Centre, Gusau, Zamfara, Nigeria
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Oladayo AM, Prochaska S, Busch T, Adeyemo WL, Gowans LJ, Eshete M, Awotoye W, Sule V, Alade A, Adeyemo AA, Mossey PA, Prince A, Murray JC, Butali A. Parents and Provider Perspectives on the Return of Genomic Findings for Cleft Families in Africa. AJOB Empir Bioeth 2024; 15:133-146. [PMID: 38236653 PMCID: PMC11153024 DOI: 10.1080/23294515.2024.2302993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
BACKGROUND Inadequate knowledge among health care providers (HCPs) and parents of affected children limits the understanding and utility of secondary genetic findings (SFs) in under-represented populations in genomics research. SFs arise from deep DNA sequencing done for research or diagnostic purposes and may burden patients and their families despite their potential health importance. This study aims to evaluate the perspective of both groups regarding SFs and their choices in the return of results from genetic testing in the context of orofacial clefts. METHODS Using an online survey, we evaluated the experiences of 252 HCPs and 197 parents across participating cleft clinics in Ghana and Nigeria toward the return of SFs across several domains. RESULTS Only 1.6% of the HCPs felt they had an expert understanding of when and how to incorporate genomic medicine into practice, while 50.0% agreed that all SFs should be returned to patients. About 95.4% of parents were willing to receive all the information from genetic testing (including SFs), while the majority cited physicians as their primary information source (64%). CONCLUSIONS Overall, parents and providers were aware that genetic testing could help in the clinical management of diseases. However, they cited a lack of knowledge about genomic medicine, uncertain clinical utility, and lack of available learning resources as barriers. The knowledge gained from this study will assist with developing guidelines and policies to guide providers on the return of SFs in sub-Saharan Africa and across the continent.
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Affiliation(s)
- Abimbola M Oladayo
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Sydney Prochaska
- Department of Global Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Wasiu L. Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos
| | - Lord J.J. Gowans
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- Addis Ababa University, School of Medicine, Department of Surgery, Addis Ababa, Ethiopia
| | - Waheed Awotoye
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Azeez Alade
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A. Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | | | - Azeez Butali
- Department Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
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Oladayo AM, Odukoya O, Sule V, Molobe I, Busch T, Akodu B, Adeyemo WL, Gowans LJJ, Eshete M, Alade A, Awotoye W, Adeyemo AA, Mossey PA, Prince AER, Murray JC, Butali A. Perceptions and beliefs of community gatekeepers about genomic risk information in African cleft research. BMC Public Health 2024; 24:507. [PMID: 38365612 PMCID: PMC10873930 DOI: 10.1186/s12889-024-17987-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND A fundamental ethical issue in African genomics research is how socio-cultural factors impact perspectives, acceptance, and utility of genomic information, especially in stigmatizing conditions like orofacial clefts (OFCs). Previous research has shown that gatekeepers (e.g., religious, political, family or community leaders) wield considerable influence on the decision-making capabilities of their members, including health issues. Thus, their perspectives can inform the design of engagement strategies and increase exposure to the benefits of genomics testing/research. This is especially important for Africans underrepresented in genomic research. Our study aims to investigate the perspectives of gatekeepers concerning genomic risk information (GRI) in the presence of OFCs in a sub-Saharan African cohort. METHODS Twenty-five focus group discussions (FGDs) consisting of 214 gatekeepers (religious, community, ethnic leaders, and traditional birth attendants) in Lagos, Nigeria, explored the opinions of participants on genomic risk information (GRI), OFC experience, and the possibility of involvement in collaborative decision-making in Lagos, Nigeria. Transcripts generated from audio recordings were coded and analyzed in NVivo using thematic analysis. RESULTS Three main themes-knowledge, beliefs, and willingness to act-emerged from exploring the perspective of gatekeepers about GRI in this group. We observed mixed opinions regarding the acceptance of GRI. Many participants believed their role is to guide and support members when they receive results; this is based on the level of trust their members have in them. However, participants felt they would need to be trained by medical experts to do this. Also, religious and cultural beliefs were crucial to determining participants' understanding of OFCs and the acceptance and utilization of GRI. CONCLUSIONS Incorporating cultural sensitivity into public engagement could help develop appropriate strategies to manage conflicting ideologies surrounding genomic information in African communities. This will allow for more widespread access to the advances in genomics research in underrepresented populations. We also recommend a synergistic relationship between community health specialists/scientists, and community leaders, including spiritual providers to better understand and utilize GRI.
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Affiliation(s)
- Abimbola M Oladayo
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
| | - Oluwakemi Odukoya
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Veronica Sule
- Department of Operative Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Ikenna Molobe
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Tamara Busch
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Babatunde Akodu
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - Lord J J Gowans
- Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Mekonen Eshete
- School of Medicine, Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - Waheed Awotoye
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA
| | | | - Peter A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | | | - Jeffrey C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
- Iowa Institute of Oral Health Research, University of Iowa, Iowa City, IA, USA.
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Boschen KE, Dragicevich CJ, Fish EW, Hepperla AJ, Simon JM, Parnell SE. Gastrulation-stage alcohol exposure induces similar rates of craniofacial malformations in male and female C57BL/6J mice. Birth Defects Res 2024; 116:e2292. [PMID: 38116840 PMCID: PMC10872400 DOI: 10.1002/bdr2.2292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 11/18/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Prenatal alcohol exposure during gastrulation (embryonic day [E] 7 in mice, ~3rd week of human pregnancy) impairs eye, facial, and cortical development, recapitulating birth defects characteristic of Fetal Alcohol Syndrome (FAS). However, it is not known whether the prevalence or severity of craniofacial features associated with FAS is affected by biological sex. METHODS The current study administered either alcohol (2.9 g/kg, two i.p. doses, 4 hr apart) or vehicle to pregnant C57BL/6J females on E7, prior to gonadal sex differentiation, and assessed fetal morphology at E17. RESULTS Whereas sex did not affect fetal size in controls, alcohol-exposed females were smaller than both control females and alcohol-treated males. Alcohol exposure increased the incidence of eye defects to a similar degree in males and females. Together, these data suggest that females might be more sensitive to the general developmental effects of alcohol, but not effects specific to the craniofacies. Whole transcriptomic analysis of untreated E7 embryos found 214 differentially expressed genes in females vs. males, including those in pathways related to cilia and mitochondria, histone demethylase activity, and pluripotency. CONCLUSION Gastrulation-stage alcohol induces craniofacial malformations in male and female mouse fetuses at similar rates and severity, though growth deficits are more prevalent females. These findings support the investigation of biological sex as a contributing factor in prenatal alcohol studies.
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Affiliation(s)
- Karen E. Boschen
- Bowles Center for Alcohol Studies, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Constance J. Dragicevich
- Bowles Center for Alcohol Studies, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eric W. Fish
- Bowles Center for Alcohol Studies, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Austin J. Hepperla
- Carolina Institute for Developmental Disabilities, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jeremy M. Simon
- Carolina Institute for Developmental Disabilities, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Genetics, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott E. Parnell
- Bowles Center for Alcohol Studies, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Cell Biology and Physiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Shivlani VI, Niranjane PP, Diagavane PS, Madhu PP. Demographic Profile of Patients with Cleft Lip and Palate Anomaly: 15-year Experience from a Tertiary Care Hospital and Teaching Institute in Wardha District of Maharashtra, India. Int J Clin Pediatr Dent 2023; 16:278-282. [PMID: 38268625 PMCID: PMC10804307 DOI: 10.5005/jp-journals-10005-2675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Background Cleft lip and palate (CLP) is considered to be a congenital defect involving the orofacial region. This defect affects the esthetics, speech as well and psychological well-being of a person. The study was performed to analyze the prevalence of different types of cleft deformity reported in a tertiary care hospital which would aid in spreading awareness and thereby reducing the prevalence of this congenital defect. Aim To study the demographic profile of patients with CLP in the Wardha region. Materials and methods A single-center retrospective cross-sectional study was performed. The patients with cleft deformity report under the "Smile Train Project" under the Department of Orthodontics and Dentofacial Orthopedics along with the Department of Oral and Maxillofacial Surgery. The data retrieved included the name of the patient, age, gender, residential address, contact details, and type of cleft. This data was segregated focusing on the gender and type of cleft as per the concern of this study. The datasets were then entered in the Microsoft Excel sheet and the statistical graphical representation was done using Microsoft PowerPoint. Results In the present study we tried to find out the profile of CLP in the local population. We reported the high prevalence of this orofacial deformity among the population of this area. Conclusion The data from the present study will help to provide a deeper insight into the burden of CLP anomaly. Based on the data obtained from the present study, future research can be conducted, and cleft-care improvement outcomes can be measured. Clinical significance There are several etiological factors that are responsible for the development of CLP. Also, due to a lack of awareness regarding this, there is an increased prevalence of this defect. In India, due to a lack of knowledge regarding cleft anomaly, poverty, and social stigma, many patients do not report to the hospitals, and hence, there is a need to spread awareness which would encourage people to access the healthcare facilities at an early age and would reduce the complications in later stages. How to cite this article Shivlani VI, Niranjane PP, Diagavane PS, et al. Demographic Profile of Patients with Cleft Lip and Palate Anomaly: 15-year Experience from a Tertiary Care Hospital and Teaching Institute in Wardha District of Maharashtra, India. Int J Clin Pediatr Dent 2023;16(S-3):S278-S282.
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Affiliation(s)
- Vinus I Shivlani
- Department of Orthodontics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Sawangi, Wardha, Maharashtra, India
| | - Priyanka P Niranjane
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Sawangi, Wardha, Maharashtra, India
| | - Pallavi S Diagavane
- Department of Orthodontics and Dentofacial Orthopedics, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Sawangi, Wardha, Maharashtra, India
| | - Priyanka P Madhu
- Department of Public Health Dentistry, Sharad Pawar Dental College, Datta Meghe Institute of Higher Education & Research, Sawangi, Wardha, Maharashtra, India
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Eo MY, Thi Hoang Nguyen T, Amponsah EK, Sodnom-Ish B, Frimpong P, Yang HJ, Kim SM. Remote Real-Time Training for Sustainable Cleft Operation in Rural Region of West Africa: Effective Webinar in the COVID-19 Pandemic. J Craniofac Surg 2023:00001665-990000000-01097. [PMID: 37750711 DOI: 10.1097/scs.0000000000009759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/04/2023] [Indexed: 09/27/2023] Open
Abstract
INTRODUCTION The surgical requirement for cleft lip and palate repair remains unmet in many developing areas of the world, including remote regions of Ghana. This article reviews the utilization of Internet education and online consultation for cleft lip and palate surgical training in Sunyani Regional Hospital (SRH), Ghana. METHODS The cleft lip and palate treatment was promoted to patients in remote areas of Sunyani, Ghana region, through a charitable outreach program. These basic designs and settings were managed by local participants such as doctors, residents, nurses, and staff in SRH, Ghana. RESULTS From November 2014 to December 2020, the authors collaborated in surgical treatment for 84 cases that were diagnosed with unilateral cleft lip, bilateral cleft lip, hard and soft palate cleft, and microstomia. The type of surgery has varied and has included cheiloplasty, palatoplasty, and others. The average scores of esthetic outcome evaluation were nasal form=2.4, symmetry of the nose=2.9, and vermillion border=2.9. Through the program, the surgeons and residents became significantly more proficient at cleft lip and palate surgery. The seminar topics have covered essential and sustainable topics based on SRH's current needs and showed the effectiveness in the current coronavirus disease-19 pandemic situation. CONCLUSIONS The shortage of orofacial cleft surgeons working in rural areas like Sunyani, Ghana, remains an obstacle that poses a challenge to any effort to improve health care quality in these rural communities. Sustainable remote education is essential for the training of local cleft surgeons to fill this local need; our collaborative and charitable program could be a recommended education design for cleft surgeons and institutes for their sustainable education.
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Affiliation(s)
- Mi Young Eo
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Truc Thi Hoang Nguyen
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Emmanuel K Amponsah
- Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana
| | - Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Paul Frimpong
- Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
- Oral and Maxillofacial Microvascular Reconstruction LAB, Brong Ahafo Regional Hospital, Sunyani, Ghana
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Abdullahi MAS, James O, Olasoji HO, Adeyemo WL. Evaluation of the Effect of Surgical Repair on Lip-Nose Morphometric Parameters of Patients with Unilateral Cleft Lip using Two-Dimensional Photogrammetry: A Comparative Study between the Cleft and the Non-Cleft Side. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2023; 13:73-77. [PMID: 37228882 PMCID: PMC10204918 DOI: 10.4103/jwas.jwas_257_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/02/2023] [Indexed: 05/27/2023]
Abstract
Background This prospective, comparative study was carried out to evaluate the effect of cleft lip repair on lip-nose morphometric characteristics of subjects with complete unilateral cleft lip/palate at the University of Maiduguri Teaching Hospital, Borno State, Nigeria. Materials and Methods The study population consisted of a total of 29 subjects. Lip repair was done using Millard's rotation advancement technique by a single consultant. Standardised photographs were taken; preoperatively and during different postoperative periods; immediately, 1 week, 3, and 6 months. Indirect measurements of eight linear distances were carried out using Rulerswift software application. For all statistical analyses of mean difference, a P-value of less than 0.05 was accepted as being statistically significant. Results A total of 52% were women, whereas 44% were men. There are considerable disparities between the cleft and non-cleft sides of complete unilateral cleft patients before surgery; statistically significant differences of 1.4 mm, 6.3 mm, and -17.6 mm in vertical lip height, philtral height, and nasal width respectively. Six months after repair, statistically significant differences in lip height between the cleft and the non-cleft side were observed in vertical lip height, nasal width, and philtral height (mean difference of -1.28 ± 0.78, 2.02 ± 2.86, 1.22 ± 1.83 mm; P < 0.001, P = 0.016, P = 0.022, respectively). Horizontal lip height was maintained with no statistically significant difference (mean difference of -0.12 ± 2.19 mm). Conclusion Following cleft repair, using Millard's rotation advancement technique, differences in lip-nose morphometric parameters were found to be reduced, however, not always eliminated by treatment.
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Affiliation(s)
- Mohammed Adam Sheikh Abdullahi
- Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Olutayo James
- Department of Oral and Maxillofacial Surgery, Lagos University of Maiduguri Teaching Hospital, Lagos, Nigeria
| | - Hector Oladapo Olasoji
- Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, Lagos University of Maiduguri Teaching Hospital, Lagos, Nigeria
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Edetanlen EB, Lawani U, Sadoh WE, Egbor EP. Prevalence and Associated Factors of Congenital Heart Disease in Cleft Lip and Palate Patients at the University of Benin Teaching Hospital. Niger Med J 2023; 64:54-60. [PMID: 38887435 PMCID: PMC11180280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024] Open
Abstract
Background The prevalence of congenital heart disease in patients with cleft lip and palate varies from place to place. There is a paucity of such studies in our region. This study aimed to determine the prevalence and risk factors for congenital heart defects (CHD) in children with oral clefts at the University of Benin Teaching Hospital. Methodology This was a retrospective study of patients with cleft lip and palate who had echocardiography in the Department of Oral and Maxillofacial Surgery of the University of Benin Teaching Hospital (UBTH) from April 2012 to April 2022. Data were collected from the patient's case notes and the echocardiography registry in the pediatric cardiology unit of the same hospital. Both descriptive and inferential statistics were performed. In inferential statistics, the association between the prevalence of CHD and the studied variables was performed with the Chi-square test. Data were analyzed using Statistical Package for the Social Sciences, version 21. Results A total of 225 patients comprising 131 females and 94 males were recruited. The age range was 3 days to 10 years with a median age of 0.6 years. Of the 225 patients, 24(10.7%) had CHD giving a prevalence of 10.7 %. The most common CHDs were atrial septal defect 12(5.33%) and ventricular septal defect 4(1.78%). The prevalence of CHD was significantly (p= 0.02) higher in the patients living outside the study environment compared to those within the study location, and in those with isolated cleft palate (p=0.03) compared to other types of orofacial cleft. Conclusions The prevalence of CHD is relatively high among cleft lip and palate patients. The residential location and the type of orofacial cleft were associated with higher prevalence in this study.
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Affiliation(s)
| | - Ufadime Lawani
- Department of Family Dentistry, University of Benin Teaching Hospital, Benin-city, Nigeria
| | | | - Esezobor Peter Egbor
- Department of Pediatrics, University of Benin Teaching Hospital, Benin-city, Nigeria
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Sudi SM, Kabbashi S, Roomaney IA, Aborass M, Chetty M. The genetic determinants of oral diseases in Africa: The gaps should be filled. FRONTIERS IN ORAL HEALTH 2022; 3:1017276. [PMID: 36304994 PMCID: PMC9593064 DOI: 10.3389/froh.2022.1017276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
Oral diseases are a major health concern and are among the most prevalent diseases globally. This problem is becoming more prominent in the rapidly growing populations of Africa. It is well documented that Africa exhibits the most diverse genetic make-up in the world. However, little work has been conducted to understand the genetic basis of oral diseases in Africans. Oral health is often neglected and receives low prioritisation from funders and governments. The genetic determinants of highly prevalent oral diseases such as dental caries and periodontal disease, and regionally prevalent conditions such as oral cancer and NOMA, are largely under-researched areas despite numerous articles alluding to a high burden of these diseases in African populations. Therefore, this review aims to shed light on the significant gaps in research on the genetic and genomic aspects of oral diseases in African populations and highlights the urgent need for evidence-based dentistry, in tandem with the development of the dentist/scientist workforce.
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Naicker T, Adeleke CC, Alade A, Mossey PA, Awotoye WA, Busch TD, Li M, Olotu J, Gowans LJJ, Aldous C, Butali A. Novel GRHL3 Variants in a South African Cohort With Cleft Lip and Palate. Cleft Palate Craniofac J 2022; 59:1125-1130. [PMID: 34459660 PMCID: PMC9790085 DOI: 10.1177/10556656211038453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The etiology of cleft palate (CP) is poorly understood compared with that of cleft lip with or without palate (CL ± P). Recently, variants in Grainyhead like transcription factor 3 (GRHL3) were reported to be associated with a risk for CP in European and some African populations including Nigeria, Ghana, and Ethiopia. In order to identify genetic variants that may further explain the etiology of CP, we sequenced GRHL3 in a South African population to determine if rare variants in GRHL3 are associated with the presence of syndromic or nonsyndromic CP. DESIGN We sequenced the exons of GRHL3 in 100 cases and where possible, we sequenced the parents of the individuals to determine the segregation pattern and presence of de novo variants. SETTING The cleft clinics from 2 public, tertiary hospitals in Durban, South Africa (SA), namely Inkosi Albert Luthuli Central Hospital and KwaZulu-Natal Children's Hospital. PATIENTS, PARTICIPANTS One hundred patients with CL ± P and their parents. INTERVENTIONS Saliva samples were collected. MAIN OUTCOME MEASURES To ascertain the genetic variants in the GRHL3 gene in patients with CL ± P in SA. RESULTS Five variants in GRHL3 were observed; 3 were novel and 2 were known variants. The novel variants were intronic variants (c.1062 + 77A>G and c.627 + 1G>A) and missense variant (p.Asp169Gly). CONCLUSIONS This study provides further evidence that variants in GRHL3 contribute to the risk of nonsyndromic CP in African populations, specifically, in the South African population.
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Affiliation(s)
- Thirona Naicker
- Department of Paediatrics, Clinical Genetics, 72753University of KwaZulu-Natal and Inkosi Albert Luthuli Central Hospital, Durban, South Africa
- Smile Train Partner
| | - Chinyere C Adeleke
- Department of Oral Pathology, Radiology and Medicine, 573932College of Dentistry, 50699The University of Iowa, Iowa City, IA, USA
| | - Azeez Alade
- Department of Oral Pathology, Radiology and Medicine, 573932College of Dentistry, 50699The University of Iowa, Iowa City, IA, USA
| | - Peter A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
- Smile Train Global Medical Advisory Board, USA
| | - Waheed A Awotoye
- Department of Oral Pathology, Radiology and Medicine, 573932College of Dentistry, 50699The University of Iowa, Iowa City, IA, USA
| | - Tamara D Busch
- Department of Oral Pathology, Radiology and Medicine, 573932College of Dentistry, 50699The University of Iowa, Iowa City, IA, USA
| | - Mary Li
- Department of Oral Pathology, Radiology and Medicine, 573932College of Dentistry, 50699The University of Iowa, Iowa City, IA, USA
| | - Joy Olotu
- Department of Anatomy, 327041University of Port Harcourt, Rivers State, Nigeria
| | - Lord J J Gowans
- Department of Biochemistry and Biotechnology, 98763Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Colleen Aldous
- School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, 573932College of Dentistry, 50699The University of Iowa, Iowa City, IA, USA
- Smile Train Research and Innovation Advisory Council, USA
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Michael A, Olusaya A. Health-related quality of life and facial function in children with repaired cleft palate attending a speech camp: A descriptive cross-sectional study. NIGERIAN JOURNAL OF MEDICINE 2022. [DOI: 10.4103/njm.njm_42_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Eshete M. Pattern of Orofacial Clefts at A Tertiary Care Hospital in Ethiopia. Ethiop J Health Sci 2021; 31:1175-1184. [PMID: 35392346 PMCID: PMC8968373 DOI: 10.4314/ejhs.v31i6.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/13/2021] [Indexed: 11/07/2022] Open
Abstract
Background Clefts of the lip and/or palate are the most common craniofacial birth defects. The worldwide birth prevalence is 1/700 live births. There are varying reports from Africa. This study investigated the patterns of orofacial clefts at a tertiary care hospital in Addis Ababa. Methods A retrospective descriptive study was performed to assess the patterns of Orofacial clefts at the main cleft care center in Ethiopia. The Data of cleft patients operated at the main cleft care center in Ethiopia from January 2007 to April 2020 with the support of Smile Train was used for this study. Their demographic and clinical data was retrieved from the Smile Train data base and analyzed using Stata version 16. Results A total of 1919 patients' data was retrieved, excluding 16 patients' data (.83%). The data of 1903 (99.17%) patients were enrolled in this study. Cleft lip and palate were found in 53.0% of the patients. Cleft lip only was found in 731 (38.4%) and cleft palate only in 166 (8.6%) patients. The commonest surgery performed was primary unilateral lip nose repair. Most patients were operated after the age of five years old. Conclusion Many were operated after the age of five years, which is not in line with international recommendations. This needs improvement: establish more cleft care centers, distribute health care information and education.
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Affiliation(s)
- Mekonen Eshete
- Consultant Plastic and Reconstructive Surgeon Surgical Department, School of Medicine, College of Health Sciences Addis Ababa University; Members of the Smile Train Research & Innovation Advisory Council; Head Yekatit 12 Hospital Medical College Plastic and Reconstructive unit
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Awotoye W, Comnick C, Pendleton C, Zeng E, Alade A, Mossey PA, Gowans LJJ, Eshete MA, Adeyemo WL, Naicker T, Adeleke C, Busch T, Li M, Petrin A, Olotu J, Hassan M, Pape J, Miller SE, Donkor P, Anand D, Lachke SA, Marazita ML, Adeyemo AA, Murray JC, Albokhari D, Sobreira N, Butali A. Genome-wide Gene-by-Sex Interaction Studies Identify Novel Nonsyndromic Orofacial Clefts Risk Locus. J Dent Res 2021; 101:465-472. [PMID: 34689653 DOI: 10.1177/00220345211046614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Risk loci identified through genome-wide association studies have explained about 25% of the phenotypic variations in nonsyndromic orofacial clefts (nsOFCs) on the liability scale. Despite the notable sex differences in the incidences of the different cleft types, investigation of loci for sex-specific effects has been understudied. To explore the sex-specific effects in genetic etiology of nsOFCs, we conducted a genome-wide gene × sex (GxSex) interaction study in a sub-Saharan African orofacial cleft cohort. The sample included 1,019 nonsyndromic orofacial cleft cases (814 cleft lip with or without cleft palate and 205 cleft palate only) and 2,159 controls recruited from 3 sites (Ethiopia, Ghana, and Nigeria). An additive logistic model was used to examine the joint effects of the genotype and GxSex interaction. Furthermore, we examined loci with suggestive significance (P < 1E-5) in the additive model for the effect of the GxSex interaction only. We identified a novel risk locus on chromosome 8p22 with genome-wide significant joint and GxSex interaction effects (rs2720555, p2df = 1.16E-08, pGxSex = 1.49E-09, odds ratio [OR] = 0.44, 95% CI = 0.34 to 0.57). For males, the risk of cleft lip with or without cleft palate at this locus decreases with additional copies of the minor allele (p < 0.0001, OR = 0.60, 95% CI = 0.48 to 0.74), but the effect is reversed for females (p = 0.0004, OR = 1.36, 95% CI = 1.15 to 1.60). We replicated the female-specific effect of this locus in an independent cohort (p = 0.037, OR = 1.30, 95% CI = 1.02 to 1.65), but no significant effect was found for the males (p = 0.29, OR = 0.86, 95% CI = 0.65 to 1.14). This locus is in topologically associating domain with craniofacially expressed and enriched genes during embryonic development. Rare coding mutations of some of these genes were identified in nsOFC cohorts through whole exome sequencing analysis. Our study is additional proof that genome-wide GxSex interaction analysis provides an opportunity for novel findings of loci and genes that contribute to the risk of nsOFCs.
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Affiliation(s)
- W Awotoye
- Iowa Institute for Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - C Comnick
- Division of Biostatistics and Computational Biology, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - C Pendleton
- Division of Biostatistics and Computational Biology, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - E Zeng
- Division of Biostatistics and Computational Biology, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - A Alade
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.,Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - P A Mossey
- Department of Orthodontics, University of Dundee, Dundee, UK
| | - L J J Gowans
- Komfo Anokye Teaching Hospital and Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - M A Eshete
- Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - W L Adeyemo
- Department of Oral and Maxillofacial Surgery, University of Lagos, Lagos, Nigeria
| | - T Naicker
- Department of Pediatrics, University of KwaZulu-Natal, Durban, South Africa
| | - C Adeleke
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - T Busch
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - M Li
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - A Petrin
- Iowa Institute for Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - J Olotu
- Department of Anatomy, University of Port Harcourt, Choba, Nigeria
| | - M Hassan
- Department of Orthodontics, University of Dundee, Dundee, UK
| | - J Pape
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - S E Miller
- Iowa Institute for Oral Health Research, University of Iowa, Iowa City, IA, USA
| | - P Donkor
- Department of Orthodontics, University of Dundee, Dundee, UK
| | - D Anand
- Department of Biological Sciences, University of Delaware, Newark, DE, USA
| | - S A Lachke
- Department of Biological Sciences, University of Delaware, Newark, DE, USA.,Center for Bioinformatics and Computational Biology, University of Delaware, Newark, DE, USA
| | - M L Marazita
- Center for Craniofacial and Dental Genetics, Departments of Oral Biology and Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - A A Adeyemo
- National Human Genomic Research Institute, Bethesda, MD, USA
| | - J C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - D Albokhari
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - N Sobreira
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - A Butali
- Iowa Institute for Oral Health Research, University of Iowa, Iowa City, IA, USA.,Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
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Abstract
BACKGROUND Orofacial clefts are one of the most common congenital anomalies, but this disease burden is unevenly distributed worldwide. The authors hypothesize that this burden falls disproportionately on the countries with the smallest surgical workforce or lowest Socio-Demographic Index, rather than those with the highest prevalence of disease. METHODS The authors estimated the prevalence and disease burden of orofacial clefting from 1990 to 2017 in 195 countries using the Global Burden of Disease methodology. Prevalence and disability-adjusted life-years were compared geographically, temporally, and against the size of the national surgical workforce, Socio-Demographic Index, and income status. Linear and logarithmic regressions were performed. RESULTS In 2017, the prevalence of orofacial clefting was estimated to be 10.8 million people, representing a disease burden of 652,084 disability-adjusted life-years, with most of this disease burden experienced by low- and middle-income countries (94.1%). From 1990 to 2017, there was a decrease in disease burden (-70.2%) and prevalence (-4.9%). There was negative logarithmic association between surgical workforce size and disease burden, with a surgical workforce of greater than six providers per 100,000 population (3.6 disability-adjusted life-years versus 22.4 disability-adjusted life-years per 100,000 population; p < 0.0001). CONCLUSIONS Burden of orofacial clefting has a strong negative association with the size of the surgical workforce, suggesting that strengthening the surgical workforce will help alleviate this burden. Epidemiologic data on countries and regions with inadequate surgical workforces and high disease burden should guide future research efforts and allocation of resources, and guide the treatment and educational goals of international charitable organizations.
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Missense Variants Within GJB2 Gene Locus and the Risk of Hearing Defects in Nonsyndromic Cleft Lip and Palate. J Craniofac Surg 2021; 32:e676-e678. [PMID: 34224455 DOI: 10.1097/scs.0000000000007921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
AIM The aim of the study was to investigate the role of variants in GJB2 gene in the etiology of hearing defects in nonsyndromic cleft lip/palate. METHOD Saliva samples were obtained from cases (subjects with orofacial clefts) and control (subjects without orofacial clefts) who consented to the study. Deoxyribonucleic acid (DNA) was extracted using standardized protocol at Butali Lab (Iowa, IA). Primers for the coding region of GJB2 was designed using Primer 3 (http://bioinfo.ut.ee/primer3-0.4.0/) and optimized in the Butali lab using a gradient polymerase chain reaction to determine the annealing temperature for each primer set (forward and reverse). We measured the DNA concentration using Qubit and XY genotyping done for quality control. A concentration of 5 ng/μL of DNA was used for Sanger sequencing. RESULTS A total of 150 subjects were sequenced (66 cases; 84 controls). Mutations in GJB2 gene were detected in 2 individuals with cleft palate. We found p.Arg165Trp variant in 1 case and p.Leu81Val variant in the second case. Although p.Arg165Trp was predicted to be either benign or tolerated by SIFT/POLYPHEN, the single nucleotide change from C>T, that is, CGG>TGG leads to a premature stop codon preventing the protein formation. The p.Leu81Val variant was predicted to be probably damaging/ deleterious. CONCLUSIONS The present study implicates variants in the GJB2 gene in the etiology of hearing defects in nonsyndromic cleft lip and palate in the Nigerian population. Screening for variations in GJB2 gene is important for genetic counseling especially in high-risk families.
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Does the Initial Width of Cleft Lip Play a Role in the Occurrence of Immediate Local Complications Following Primary Cleft Lip Repairs? J Craniofac Surg 2021; 32:670-674. [PMID: 33705006 DOI: 10.1097/scs.0000000000007179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Among the several factors implicated in the occurrence of local surgical site complications following cleft lip repair is the initial width of the cleft. The aim of the study was to examine the effect of cleft width in the occurrence of immediate local surgical site complications. MATERIAL AND METHODS All consecutive subjects with diagnosis of unilateral or bilateral cleft lip with or without cleft palate who presented at the cleft clinic and satisfied the inclusion criteria were recruited in the study. The width of the cleft lip defect as adopted for the study was measured from the peak of the Cupid bow on the non-cleft side to a point where the white roll begins to thin out on the cleft side. Measurement was done using a Vernier Calliper. Surgery was performed under general anesthesia after which subjects were evaluated for the presence or absence of immediate local surgical site complications which included dehiscence, infection, and vermillion notching of the lip. RESULTS A total of 70 subjects consisting of 36 (51.4%) males and 34 (48.6%) females were included in the study. Mean age (±SD) was 9.0 ± (19.4) months with age range of 3 months to 13 years. The prevalence of early surgical site complications was 24.3%. The width of cleft above a critical level (14 mm) statistically correlate significantly with the occurrence of early surgical site complications (P = 0.048). CONCLUSION This study showed that the width of cleft lip of and above critical level of 14 mm may be associated with a clinically significant risk of immediate local surgical site complications.
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Osman MAK, Aljezoli MHI, Alsadig MAM, Suliman AM. Referral pattern of oral and maxillofacial surgery cases in Sudan: A retrospective age-and sex-specific analysis of 3,478 patients over four years. PLoS One 2021; 16:e0249140. [PMID: 33780490 PMCID: PMC8007037 DOI: 10.1371/journal.pone.0249140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/11/2021] [Indexed: 11/18/2022] Open
Abstract
Oral and maxillofacial surgery (OMFS) is a specialty widening in its scope. An objective analysis of the referral pattern can provide essential information to improve healthcare. This four-year retrospective study was implemented in Khartoum Teaching Dental Hospital. Data (age, sex, diagnosis, and type of treatment) were collected from patient records. Disease frequency, as well as the effect of sex and age, were analyzed for each group. The frequency of treatment types was also assessed. Data were collected from a total of 3,478 patients over the four-year study period. There was a male predominance with the third decade of life being the most common age group. Pathological diseases were the most common (37%) reason for referral, followed by trauma (31%). Temporomandibular joint (TMJ) disorders and dentoalveolar extraction were the least frequently observed. Open reduction and internal fixation (ORIF) was the most commonly performed procedure (28%). These data represent the epidemiology of oral and maxillofacial diseases in Sudan. Given that the third decade of life is the most represented age group, it is beneficial to learn the long-term consequences of these diseases in these young patients and to use modern surgical techniques to improve their lives.
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Affiliation(s)
- Musadak Ali Karrar Osman
- Faculty of Dental Medicine and Surgery, Oral & Maxillofacial Department, National University, Khartoum, Sudan
| | | | | | - Ahmed Mohamed Suliman
- Faculty of Dentistry, Maxillofacial Surgery Department, University of Khartoum, Khartoum, Sudan
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Ogamba CF, Roberts AA, Babah OA, Ikwuegbuenyi CA, Ologunja OJ, Amodeni OK. Correlates of knowledge of genetic diseases and congenital anomalies among pregnant women attending antenatal clinics in Lagos, South-West Nigeria. Pan Afr Med J 2021; 38:310. [PMID: 34178228 PMCID: PMC8197039 DOI: 10.11604/pamj.2021.38.310.26636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/15/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction genetic diseases and congenital anomalies place a significant burden on the health of new-borns and their mothers. Despite the availability of a variety of prenatal screening tests, mothers' knowledge has been documented to determine uptake. This study aims to assess the knowledge of pregnant women about birth defects and the associated correlates with regard to willingness to do prenatal screening. Methods a cross-sectional descriptive study was conducted among 422 antenatal mothers recruited sequentially as they attended antenatal clinics at the Lagos University Teaching Hospital. An interviewer-administered questionnaire was used to determine their knowledge of birth defects and willingness to do prenatal testing. Results majority of the participants (92.2%) had at least secondary education. The mean total knowledge score of the respondents was 63%. Age and knowledge scores were not significantly correlated (r=-0.071, p=0.14). Being employed predicted higher knowledge scores (95% CI: 0.09, 2.09, p=0.03). Respondents who had primary school education and those who replied “I don't know” to willingness to test had significantly lower knowledge scores (95% CI: -15.01, -1.19, p=0.02 and 95% CI: -4.52, -0.68, p=0.01 respectively). Majority (79.1%) of the respondents were willing to undergo testing. Respondents' level of education was significantly associated with willingness to test (p=0.03). Conclusion the observed knowledge gaps were considerable. There is need for improvement in education, the empowerment of women and access to quality healthcare including prenatal screening.
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Affiliation(s)
| | - Alero Ann Roberts
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Ochuwa Adiketu Babah
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Surulere, Lagos, Nigeria
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daCosta OO, Isiekwe IG, Ogbonna CM. Cleft Care in a Developing Country: An Assessment of Knowledge and Attitudes of Patients/Parents of Children With an Orofacial Cleft to Orthodontic Treatment. Cleft Palate Craniofac J 2021; 59:192-199. [PMID: 33715465 DOI: 10.1177/1055665621998179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess the knowledge, awareness and attitude to orthodontic treatment of patients and parents of children with orofacial clefts, receiving comprehensive cleft care treatment. DESIGN Cross-sectional survey. SETTING A major tertiary health care facility in Nigeria, the Lagos University Teaching Hospital, Idi-araba, Lagos. PARTICIPANTS Patients and parents of children with orofacial clefts receiving comprehnsive cleft care. INTERVENTION Patients and parents of children with orofacial clefts were asked to complete the survey. Interviewer-administered questionnaires were used. RESULTS A total of 123 patients participated in the study, 55.3% (68) were females and 44.7% (55) were males. The majority (85.3%, 114) of patients were children aged between 0 and 5 years, while only 7.3% (9) were adults, aged 18 years and above. About one-third (41) of the respondents indicated that they felt "their teeth was not straight." Although 43.9% (54) reported that they knew that braces could be used to straighten teeth, only 13.8% of the respondents knew who an orthodontist was. Eighty percent (99) indicated that they would be willing to undergo treatment to straighten their teeth or their children/wards' teeth. CONCLUSION The majority of parents of children with clefts and adult patients attending the institution's cleft clinic had limited knowledge of orthodontics and the orthodontic care required for patients with clefts, although they had a positive attitude toward orthodontic treatment. These findings will guide the center in planning patient-centered orthodontic care for patients with clefts while also highlighting areas of importance for patient counseling and education in the orthodontic care for these patients.
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Affiliation(s)
- Oluranti Olatokunbo daCosta
- Faculty of Dental Sciences, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria
| | - Ikenna Gerald Isiekwe
- Faculty of Dental Sciences, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria
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James O, Adekunle AA, Adamson OO, Agbogidi OF, Adeyemo WL, Butali A, Ladeinde AL, Ogunlewe MO. Management of Orofacial Cleft in Nigeria - A Retrospective Study. Ann Maxillofac Surg 2020; 10:434-438. [PMID: 33708591 PMCID: PMC7943976 DOI: 10.4103/ams.ams_104_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Orofacial clefts (OFCs) are among the most common craniofacial developmental abnormalities worldwide and a significant cause of childhood morbidity and mortality. This study aimed to identify patterns of patient presentation, treatment approaches, and changes in our overall cleft care service between 2007 and 2019. Methods and Methodology A retrospective review of patients managed at a tertiary health facility in Nigeria of all OFC cases operated between 2007 and 2019 was done using the postintervention data retrieved from the Smile Train database. Data of all OFC cases operated within the period were analyzed using the Statistical Package for the Social Sciences. Descriptive statistics were performed using the Statistical Package for the Social Sciences version 20.0. Results A total number of 740 OFC surgeries were performed in 565 patients, consisting of 269 females (48.2%) and 289 males (51.8%). The majority (63%) of the patients presented before the age of 2 years. Thirty-seven percent presented with cleft lip and alveolus, 27.1% with cleft palate only, and 36.7% with cleft lip, alveolus, and palate. Primary cleft lip repair was the most performed surgery (n = 320, 43.2%), the mean age at repair was 2.1 years. Since 2017, additional services such as speech therapy, mixed dentition orthodontics, and nutritional support were added to services provided to our cleft patients. Fifteen patients have undergone speech assessment and three have completed speech treatment. Eight patients have undergone mixed dentition stage orthodontic treatment. Discussion Our services have evolved from simply providing surgical care to comprehensive care with a multidisciplinary team approach and provision of a wide range of services including nutritional counseling, pediatric care, orthodontic services, and speech therapy. We believe these will improve the overall well-being of our patients while we continue to improve on services based on clinical research outcomes.
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Affiliation(s)
- Olutayo James
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Adegbayi Adeola Adekunle
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Olawale Olatubosun Adamson
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Olushola Failat Agbogidi
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - Akinola L Ladeinde
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria
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Isiekwe IG, Ligali TO, Abdullahi MAS, Adeyemo WL. Oral Habits in Children With Orofacial Clefts: A Comparative Study. Cleft Palate Craniofac J 2020; 58:984-989. [PMID: 33176476 DOI: 10.1177/1055665620969570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM Children with cleft lip and palate present with a wide range of dental and occlusal anomalies as a result of the cleft defect. These patients also present with oral habits which may affect their quality of life. The aim of this study was to compare the prevalence of oral habits in these children, with children without orofacial clefts. METHODOLOGY This was a cross-sectional comparative study comparing children with repaired cleft lip and/or palate aged 3 to 12 years, with children without orofacial clefts. Ethical approval for the study was obtained from the institutional review boards of both centers. Data collection was via interviewer administered questionnaires given to the parents/guardians of the children in each group. Data analysis was carried out using SPSS version 23. The level of significance was set at P < .05. RESULTS A total of 107 respondents participated in the study, comprising 53 children with repaired cleft lip and/or palate 54 children without orofacial clefts. The mean age for the children with Cleft lip and/or palate/ was 6.81 (standard deviation [SD] 1.898) years, while that for the control group was 7.78 (SD 1.68) years. Two oral habits recorded a significantly higher prevalence (P < .05) in the children with repaired clefts as compared to controls and these were lip sucking and bruxism. No significant difference in prevalence was recorded for all the other oral habits surveyed. CONCLUSION A significantly higher prevalence (P < .05) was observed in lip sucking and bruxism among children with cleft lip and palate, as compared to the children without orofacial clefts.
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Affiliation(s)
- Ikenna Gerald Isiekwe
- Department of Child Dental Health, Faculty of Dental Sciences, 98002College of Medicine, University of Lagos/ Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria
| | - Taofeek Olalekan Ligali
- Department of Preventive and Child Health, Faculty of Dentistry, College of Medical Sciences, 312957University of Maiduguri/ University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria
| | - Mohammed Adam Sheikh Abdullahi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medical Sciences, 312957University of Maiduguri, Borno State, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, 98002College of Medicine, University of Lagos/Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria
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Widodo DW, Airlangga TJ, Aryanti G. Speech improvement in a child with submucous cleft palate surgery: A case report. OTOLARYNGOLOGY CASE REPORTS 2020. [DOI: 10.1016/j.xocr.2020.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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James O, Erinoso OA, Ogunlewe AO, Adeyemo WL, Ladeinde AL, Ogunlewe MO. Parental Age and the Risk of Cleft Lip and Palate in a Nigerian Population - A Case-Control Study. Ann Maxillofac Surg 2020; 10:429-433. [PMID: 33708590 PMCID: PMC7944012 DOI: 10.4103/ams.ams_134_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/07/2020] [Accepted: 05/13/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Orofacial clefts are one of the most common congenital malformations in the facial region. Older maternal or paternal age presents higher odds of a child with an orofacial cleft. The objective of the study was to assess the association between parental age and risk of orofacial cleft. Materials and Methods: This was a case–control study among 110 parents of children with orofacial cleft (case group) and 110 parents of children without orofacial cleft (control group). Information on maternal age, paternal age, and type of orofacial cleft in the children were obtained. The results were analyzed using descriptive statistics, Chi-square analysis, and bivariate logistic regressions to measure the association between parental age and orofacial cleft. The value of P was <0.05, with a 95% confidence interval (CI). Results: Information on 219 children (109 cases and 110 controls) was analyzed, of which 52% were females. One respondent from the case group withdrew from the study. The odds of a child with orofacial cleft was statistically significantly lower in mothers aged 26–35 years compared to mothers aged 25 years and less (odds ratio [OR]: 0.32; 95% CI: 0.16, 0.79). Similarly, fathers aged above 35 years had statistically significantly lower odds of children with orofacial cleft than those 25 years and less (OR: 0.18; 95% CI: 0.02, 0.99). Discussion: Our findings suggest that mothers aged 26-35 years may have lower odds of giving birth to babies with orofacial clefts, compared to younger mothers. Similarly, fathers aged above 35 years may have lower odds of giving birth to a child with orofacial cleft compared to fathers aged 25 years and less.
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Affiliation(s)
- Olutayo James
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria.,College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olufemi A Erinoso
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria
| | - Ajoke O Ogunlewe
- Department of Paediatrics, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria
| | - Wasiu L Adeyemo
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria.,College of Medicine, University of Lagos, Lagos, Nigeria
| | - Akinola L Ladeinde
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria.,College of Medicine, University of Lagos, Lagos, Nigeria
| | - Mobolanle O Ogunlewe
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos, Nigeria.,College of Medicine, University of Lagos, Lagos, Nigeria
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Onah II, Amanari CO, Onwuagha I, Jac-Okereke CA. OUTCOMES OF CLEFT PALATE SURGERIES AT THE NATIONAL ORTHOPAEDIC HOSPITAL, ENUGU, NIGERIA: NOVEMBER 2008 - NOVEMBER 2013. Ann Ib Postgrad Med 2020; 18:S39-S44. [PMID: 33071695 PMCID: PMC7513373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Despite an increase in the number of palatoplasty procedures at the National Orthopaedic Hospital Enugu (NOHE) sequel to a partnership with Smile Train, no reports on subsequent outcomes have been published. We investigated the speech outcomes and rates of fistula formation, the relationship between introduction of solids and incidence of post-operative oronasal fistulae and the benefits of post-operative honey licks. OBJECTIVE To determine the outcome of palatal repairs performed at our center in relation to the timing and nature of post-operative feeds. METHOD This was a cohort study of patients who had palatoplasty over a five-year period and were subsequently followed up for a maximum period of 9 years. The patient's present condition, timing of first feeds, onset of solid feeds, honey licks, frequency of wound dehiscence, fistula formation, and speech outcomes were assessed. The evaluation for a fistula was made from two weeks after the surgery by a senior resident in plastic surgery. Analysis was done using SPSS version 21.0 and p value set at <0.05. RESULTS A total of 115 surgeries: 90 primary cleft palate repairs, 6 combined cleft lip and palate surgeries and 19 secondary cleft palate repairs were done. Male to female ratio was 1:1.3. Age range of patients was 6 weeks to 36 years. Timing of introduction of solid meals significantly affected incidence of repair breakdown; and 58% had normal to near-normal speech. CONCLUSIONS Licking honey was associated with fewer wound breakdowns. Early return to solid feeds is associated with a higher incidence of wound breakdown following palate repair.
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Affiliation(s)
- I I Onah
- Department of Plastic Surgery, National Orthopaedic Hospital, Enugu
| | - C O Amanari
- Department of Plastic Surgery, National Orthopaedic Hospital, Enugu
| | - I Onwuagha
- Department of Plastic Surgery, National Orthopaedic Hospital, Enugu
| | - C A Jac-Okereke
- Department of Plastic Surgery, National Orthopaedic Hospital, Enugu
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Nwaze C, Adebayo O, Adeoye A, Akinmoladun V. OROFACIAL CLEFTS AND CARDIOVASCULAR RISK AND DISEASES: THE CAUSAL RELATIONSHIP AND ASSOCIATIONS. Ann Ib Postgrad Med 2020; 18:S28-S34. [PMID: 33071693 PMCID: PMC7513382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
There is a complex interplay between orofacial clefts (OFCs) or cleft of the lip and palate and cardiovascular risk factors and cardiac diseases. The presence of maternal cardiovascular risk factors serves as a potent predisposing factor to the development of OFCs during foetal development in addition to the fact that various congenital anomalies are associated with OFCs either in syndromic or non-syndrome relationship. This article narratively explores this complex interplay, which is not uncommon.
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Affiliation(s)
- C.E. Nwaze
- College of Medicine, University of Ibadan, Ibadan
| | - O. Adebayo
- Department of Medicine, University College Hospital, Ibadan
| | - A.M. Adeoye
- Department of Medicine, University of Ibadan/University College Hospital, Ibadan,Institute of Cardiovascular Diseases, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan
| | - V. Akinmoladun
- Department of Oral and Maxillofacial Surgery, University of Ibadan/University College Hospital, Ibadan
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Ács L, Bányai D, Nemes B, Nagy K, Ács N, Bánhidy F, Rózsa N. Maternal‐related factors in the origin of isolated cleft palate—A population‐based case‐control study. Orthod Craniofac Res 2020; 23:174-180. [DOI: 10.1111/ocr.12361] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/24/2019] [Accepted: 12/11/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Lili Ács
- Department of Paediatric Dentistry and Orthodontics Semmelweis University Faculty of Dentistry Budapest Hungary
| | - Dorottya Bányai
- Department of Paediatric Dentistry and Orthodontics Semmelweis University Faculty of Dentistry Budapest Hungary
| | - Bálint Nemes
- Department of Paediatric Dentistry and Orthodontics Semmelweis University Faculty of Dentistry Budapest Hungary
| | - Krisztián Nagy
- 1st Department of Paediatrics Semmelweis University School of Medicine Budapest Hungary
- OMFS‐IMPATH KU Research Group Leuven Belgium
| | - Nándor Ács
- Department of Obstetrics and Gynaecology Semmelweis University School of Medicine Budapest Hungary
| | - Ferenc Bánhidy
- Department of Obstetrics and Gynaecology Semmelweis University School of Medicine Budapest Hungary
| | - Noémi Rózsa
- Department of Paediatric Dentistry and Orthodontics Semmelweis University Faculty of Dentistry Budapest Hungary
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Adekunle AA, Adamson O, James O, Ogunlewe OM, Butali A, Adeyemo WL. Breastfeeding Practices Among Mothers of Children With Orofacial Clefts in an African Cohort. Cleft Palate Craniofac J 2020; 57:1018-1023. [PMID: 32295412 DOI: 10.1177/1055665620919312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To carry out a survey of breastfeeding practices and related challenges among mothers with orofacial cleft babies attending the cleft clinic of a tertiary health institution. METHODOLOGY This was a cross-sectional descriptive study using an interviewer-administered questionnaire. Sample population was all mothers of babies aged between 1 and 18 months with nonsyndromic orofacial clefts attending the cleft clinic of a tertiary health institution in Nigeria. RESULT A total of 65 mothers participated in the study. Initiation of breastfeeding was reported by the majority (83%, n = 54) of the mothers, and only 18.5% (n = 10) of this proportion continued exclusive breastfeeding. Inability of the babies to suck was reported by 46% (n = 30) of the mothers as being the most important challenge in breastfeeding. There was a significant correlation between the type of cleft and challenge in breastfeeding (Fisher exact P = .001). Sixty-three percent (n = 41) of the mothers reported they received no counseling on overcoming challenges associated with feeding their babies with a cleft at the facility where they delivered. Sixty-nine percent (n = 45) reported they first received nutritional information from the cleft clinic at presentation. The most adopted substitute for breastfeeding was the use of regular feeding bottles (n = 24, 43.6%). CONCLUSION Rate of initiation of breastfeeding for children with orofacial clefts in this African cohort is higher than reported in other populations despite the low level of nutritional counseling of the mothers after delivery.
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Affiliation(s)
- Adegbayi Adeola Adekunle
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-Araba, Nigeria
| | - Olawale Adamson
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| | - Olutayo James
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| | - Omobolanle M Ogunlewe
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, IA, USA
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Idi-Araba, Nigeria
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Mukami G, Angela M, Wanjala N. Epidemiological patterns of patients managed for cleft lip and palate during free outreach camps at a peripheral hospital in Kenya. JOURNAL OF CLEFT LIP PALATE AND CRANIOFACIAL ANOMALIES 2020. [DOI: 10.4103/jclpca.jclpca_8_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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AlHammad Z, Suliman I, Alotaibi S, Alnofaie H, Alsaadi W, Alhusseini S, Aldakheel G, Alsubaie N. The prevalence of non-syndromic orofacial clefts and associated congenital heart diseases of a tertiary hospital in Riyadh, Saudi Arabia. Saudi Dent J 2019; 33:137-142. [PMID: 33679106 PMCID: PMC7910677 DOI: 10.1016/j.sdentj.2019.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/03/2022] Open
Abstract
Background Orofacial clefts are considered one of the most common birth defects and are frequently associated with other malformations. Congenital heart disease is one of the most prevalent congenital malformation. Objective To investigate the prevalence of congenital heart diseases associated with non-syndromic orofacial clefts in the Saudi population. Methods Electronic files of non-syndromic orofacial cleft patients who visited the Oral and Maxillofacial Surgery Department in King Abdulaziz Medical City of Riyadh, Saudi Arabia from January 2015 to December 2018 were retrospectively reviewed. Data were recorded in an excel sheet and analyzed using SPSS via frequency tests. Results In the cleft children identified, the prevalence of non-syndromic orofacial clefts was (77%). Orofacial clefts showed a male predominance (62%). The most common orofacial phenotype was unilateral cleft lip and palate (34%). The prevalence of associated congenital malformations with orofacial clefts was (41%). The most prevalent congenital malformation was congenital heart disease (35%), mainly found in unilateral cleft lip and palate patients (33%). The prevalence of associated congenital heart disease with orofacial clefts was (19%). The most frequent type of congenital heart disease was atrial septal defect (37%). Conclusion This study highlights the recognition of the associated congenital heart disease with non-syndromic orofacial cleft patients. Global screening protocols designed for newborns with non-syndromic orofacial cleft are needed to eliminate late diagnosis of critical congenital heart diseases which might present operative risks of anesthesia and/or surgical procedures.
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Key Words
- ASD, atrial septal defect
- AVS, aortic valve stenosis
- CHD, congenital heart disease
- CL, cleft lip
- CLP, cleft lip and palate
- CP, cleft palate
- Cleft lip and palate
- Congenital heart disease
- MVP, mitral valve prolapse
- Non-syndromic
- OFC, orofacial cleft
- Orofacial cleft
- PVS, pulmonary valve stenosis
- Prevalence
- Saudi Arabia
- TGA, transposition of great arteries
- VSD, ventricular septal defect
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Affiliation(s)
- Ziyad AlHammad
- Saudi Board of Oral and Maxillofacial Surgery, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Ihab Suliman
- Department of Cardiac Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Sami Alotaibi
- Saudi Board of Oral and Maxillofacial Surgery, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Hourya Alnofaie
- Saudi Board of Oral and Maxillofacial Surgery, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia.,Division of Oral and Maxillofacial Surgery, Department of Basic Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Waad Alsaadi
- Pediatric Dentistry and Orthodontic Department, King Saud University, Riyadh, Saudi Arabia
| | - Sarah Alhusseini
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ghadah Aldakheel
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Noura Alsubaie
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Adetayo AM, Adetayo MO, Funmi A O, Somoye MS, Adeyemi MO, Adeyemo WL. Comparison of professional and laypeople evaluation of nasolabial esthetics following unilateral cleft lip repair. Eur J Dent 2019; 12:516-522. [PMID: 30369796 PMCID: PMC6178684 DOI: 10.4103/ejd.ejd_31_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives: The objective is to know the extent of agreement of clinicians’ perception of nasolabial esthetic compared to that of laypeople (parents). Materials and Methods: This was a prospective study of comparison of clinician's perception of nasolabial esthetics with that of laypeople following surgical repair of UCL. Participants were recruited from the Cleft Clinic of the Lagos University Teaching Hospital, and surgical repair of the cleft was performed under general anesthesia. Surgical evaluation was done through direct clinical evaluation using the modified form of the Christofides’ criteria by laypeople and professionals. Results: A total of 48 cleft participants were enrolled in the study. The evaluation of the lip by both the laypeople and professionals was similar, and there was no difference (0.588) in their rating. However, there was a significant disagreement (P = 0.001) between them in the nose assessment. Conclusion: Neither the solitary opinion of the professionals nor that of the laypeople is satisfactory in the evaluation of facial esthetics; both are equally important, especially in the assessment of nasal esthetics. However, opinion of either the laypeople or the professional might be enough in the evaluation of the lip esthetics.
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Affiliation(s)
- Adekunle Moses Adetayo
- Department of Surgery, Benjamin Carson Snr School of Medicine, Babcock University, Ogun State, Nigeria.,Department of Surgery, Dental Unit, Babcock University Teaching Hospital, Ogun State, Nigeria
| | | | - Oguntade Funmi A
- Department of Surgery, Benjamin Carson Snr School of Medicine, Babcock University, Ogun State, Nigeria.,Department of Anaesthesia, Babcock University Teaching Hospital, Ogun State, Nigeria
| | - Mayowa Solomon Somoye
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Michael O Adeyemi
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
| | - Wasiu Lanre Adeyemo
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos State, Nigeria
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Hlongwa P, Levin J, Rispel LC. Epidemiology and clinical profile of individuals with cleft lip and palate utilising specialised academic treatment centres in South Africa. PLoS One 2019; 14:e0215931. [PMID: 31071123 PMCID: PMC6508722 DOI: 10.1371/journal.pone.0215931] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 04/10/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE The study was conducted to determine the epidemiology and clinical profile of individuals with cleft lip and/or palate (CLP) utilizing specialized academic treatment centres in South Africa's public health sector. MATERIALS AND METHODS The Human Research Ethics Committee of the University of the Witwatersrand in Johannesburg provided ethical approval for the study. We conducted a retrospective record review of all cases of CLP treated at the specialised academic centres for the two-year period from 1 January 2013 until 31 December 2014. We used a structured, pre-tested record review form to obtain demographic, clinical and treatment information on each CLP case. We used Stata 13 to analyse the data and conducted statistical tests at 5% significance level. RESULTS We analysed 699 records of individuals with CLP. The estimated prevalence of CLP in the South African public health sector was 0.3 per 1000 live births, with provincial variation of 0.1/1000 to 1.2/1000. The distribution of clefts was: 35.3% cleft palate; 34.6% cleft lip and palate; 19.0% cleft lip and other cleft anomalies at 2%. Of the total number of CLP, 47.5% were male and 52.5% female, and this difference was statistically significant (p<0.001). The majority of clefts occurred on the left for males (35.5%) and palate for females (43.4%), with a male predominance of unilateral cleft lip and palate (53.3%). CONCLUSION The study findings should inform the implementation of South Africa's planned birth defect surveillance system and health service planning for individuals with CLP.
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Affiliation(s)
- Phumzile Hlongwa
- School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Jonathan Levin
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
| | - Laetitia C. Rispel
- Centre for Health Policy & DST/NRF SARChI Chair, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
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Michael A, Olusanya A, Olawoye O, Ademola S, Iyun A, Akinmoladun V, Oluwatosin O. STATE DISTRIBUTION OF NEW PATIENTS PRESENTING WITH CLEFT LIP AND PALATE TO THE UNIVERSITY COLLEGE HOSPITAL: A PILOT STUDY. Ann Ib Postgrad Med 2018; 16:157-161. [PMID: 31217774 PMCID: PMC6580406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
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. METHODS 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.
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Affiliation(s)
- A.I. Michael
- Department of Surgery, College of Medicine, University of Ibadan and Department of Plastic Reconstructive
and Aesthetic Surgery, University College Hospital, Ibadan
| | - A.A. Olusanya
- Department of Oral and Maxillofacial Surgery. Faculty of Dentistry. College of Medicine. University of
Ibadan
| | - O.A. Olawoye
- Department of Surgery, College of Medicine, University of Ibadan and Department of Plastic Reconstructive
and Aesthetic Surgery, University College Hospital, Ibadan
| | - S.A. Ademola
- Department of Surgery, College of Medicine, University of Ibadan and Department of Plastic Reconstructive
and Aesthetic Surgery, University College Hospital, Ibadan
| | - A.O. Iyun
- Department of Surgery, College of Medicine, University of Ibadan and Department of Plastic Reconstructive
and Aesthetic Surgery, University College Hospital, Ibadan
| | - V.I. Akinmoladun
- Department of Oral and Maxillofacial Surgery. Faculty of Dentistry. College of Medicine. University of
Ibadan
| | - O.M. Oluwatosin
- Department of Surgery, College of Medicine, University of Ibadan and Department of Plastic Reconstructive
and Aesthetic Surgery, University College Hospital, Ibadan
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Abstract
BACKGROUND The prevalence of birth defects including orofacial clefts (OFC) in Ethiopia is not known and there is no established birth defects registration system. OBJECTIVES To investigate the prevalence and incidence of OFC in Ethiopia. DESIGN Retrospective hospital-based descriptive study. METHODS The authors obtained data from the Smile Train database on Ethiopian patients with OFC who underwent surgical treatment from June 2007 to December 2013 at 31 hospitals distributed throughout the country. Data related to live births in Ethiopia during the mentioned period were obtained from the Federal Ministry of Health database for estimates of the incidence and prevalence rates. RESULTS The total number of life births during the study period was 18,811,316. During this same period, 18,073 cleft patients approximately ranging from 1 to 75 years old were examined and treated at the hospitals mentioned earlier. The incidence rate estimated from the total number of affected children during the study period (N = 8232) is 0.44/1000 live births. The prevalence rate is 0.20/1000 and this was estimated using the number of total population in 2013 (N = 88,703,914). There is a significant difference in frequency between bilateral clefts of the lip and/or palate (CLP) (26.9%) versus unilateral CLP (73.1%) (P < 0.0001). There is also a significant difference in frequency between bilateral cleft lips only (15.4%) versus unilateral cleft lip only (84.6%), P < 0001. CONCLUSION It is obvious that the findings in this study cannot be representative of the true picture but provides a previously unavailable national estimate of incidence and prevalence of OFC in Ethiopia. It can also be used as comparison for future community-based studies.
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Fan D, Wu S, Liu L, Xia Q, Tian G, Wang W, Ye S, Wang L, Rao J, Yang X, Yu Z, Xin L, Li S, Duan Z, Zhang T, Wu S, Guo X, Liu Z. Prevalence of non-syndromic orofacial clefts: based on 15,094,978 Chinese perinatal infants. Oncotarget 2018; 9:13981-13990. [PMID: 29568410 PMCID: PMC5862631 DOI: 10.18632/oncotarget.24238] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 12/05/2017] [Indexed: 12/12/2022] Open
Abstract
Non-syndromic orofacial clefts (NSOFC), which include cleft lip and palate (CLP), cleft lip only (CLO), and cleft palate only (CPO), contains a range of disorders affecting the lips and oral cavity. No systematic review and meta-analysis has been carried out to synthesize the prevalence of NSOFC in Chinese perinatal infants. We aimed to quantify and understand the variation of prevalence national and regional levels. Four English databases and four Chinese databases were searched using a comprehensive search strategy from inception to April 2017. The random effect model was used for this meta-analysis. To determine the sources of heterogeneity, subgroup analyses and meta-regression were conducted based on different categories. The protocol has been pre-registered in the PROSPERO, number CRD42017062293. 110 studies, including 15,094,978 Chinese perinatal infants, were eligible for inclusion. The pooled prevalence rate for NSOFC was 1.67‰ (95% CI 1.53–1.82), varying with provinces. The pooled prevalence estimate was 0.56‰ (0.50–0.63) for CLO, 0.82‰ (0.73–0.90) for CLP, and 0.27‰ (0.24–0.30) for CPO. Significant associations were found between overall prevalence estimates and survey year and study region. The prevalence of NSOFC was severe in Chinese perinatal infants, varying with provinces. The results will serve as a baseline for future assessment of the overall effectiveness of NSOFC control, and will also support and inform health policy for planning and helping health debates.
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Affiliation(s)
- Dazhi Fan
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.,Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China
| | - Shuzhen Wu
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.,Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China
| | - Li Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.,Department of Library, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Qing Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.,Menzies Institute for Medical Research, University of Tasmania, Private Bag 23, Hobart, Tasmania 7000, Australia
| | - Guo Tian
- Department of Library, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China
| | - Wen Wang
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China
| | - Shaoxin Ye
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.,Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China
| | - Lijuan Wang
- Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China
| | - Jiaming Rao
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.,Department of Epidemiology, Medical College of Jinan University, Guangzhou, Guangdong, 510632, China
| | - Xiao Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.,Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu, 213003, China
| | - Zhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Lihong Xin
- Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215004, China
| | - Song Li
- Chaohu Hospital Affiliated Anhui Medical University, Chaohu, Anhui, 238000, China
| | - Zhenghua Duan
- Chengdu Center for Disease Control and Prevention, Chengdu, Sichuan, 610041, China
| | - Tianchen Zhang
- Department of Communicable Diseases Control, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang 330000, Jiangxi, China
| | - Song Wu
- School of Integrated Traditional and Western Medicine, Anhui University of Chinese Medicine, Hefei, Anhui, 230038, China
| | - Xiaoling Guo
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.,Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China
| | - Zhengping Liu
- Foshan Institute of Fetal Medicine, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China.,Department of Obstetrics, Southern Medical University Affiliated Maternal and Child Health Hospital of Foshan, Foshan, Guangdong, 528000, China
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Stewart BT, Hatcher KW, Sengupta A, Burg RV. Cleft-Related Infanticide and Abandonment: A Systematic Review of the Academic and Lay Literature. Cleft Palate Craniofac J 2018; 55:98-104. [PMID: 34162058 DOI: 10.1177/1055665617721919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE We aimed to describe the scope of cleft-related infanticide and identify issues that might inform prevention strategies. DESIGN Systematic reviews of both academic (eg, PubMed, EBSCOhost) and lay literature (eg, LexisNexis Academic, Google) databases were performed to identify all primary reports of cleft-related infanticide. All languages were included. Records before 1985 were excluded. Reference lists of all included reports were screened for potentially relevant records. MAIN OUTCOME MEASURES Country of origin and excerpts that pertained to the concepts surrounding cleft-related infanticide were extracted. Extracted excerpts were examined using a content analysis framework. RESULTS Of the 1,151 records retrieved, 70 reports documented cleft-related infanticide from 27 countries. The largest number of reports was from China (14 reports; 48% of reports), followed by India (4; 14%) and Nigeria (4; 14%). However, 2 countries had 3 reports, 5 countries had 2 reports, and 17 countries had 1 report. Themes that emerged from excerpt analysis included stigma, lack of affordable cleft care, abandonment, orphanage overcrowding, and abuse and slavery. CONCLUSIONS Cleft-related infanticide is a global problem. Initiatives to sensitize communities to cleft lip and/or cleft palate, provide timely and affordable cleft care, and build support systems for affected families may prove beneficial. Cleft care organizations have the opportunity to advocate for these initiatives, reduce the incidence of infanticide by providing or supporting timely and affordable cleft care, and demonstrate that children with successful cleft repairs reassimilate well into their communities.
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Affiliation(s)
- Barclay T Stewart
- Department of Surgery, University of Washington, Seattle, WA, USA.,School of Medical Sciences, Kwame Nkrumah University of Science and, Technology, Kumasi, Ghana.,Department of Interdisciplinary Health Sciences, Stellenbosch University, Cape Town, South Africa
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38
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Ladd-Acosta C, Beaty TH. Integrating RNA Expression Identifies Candidate Gene for Orofacial Clefts. J Dent Res 2017; 97:31-32. [PMID: 29053432 DOI: 10.1177/0022034517735806] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- C Ladd-Acosta
- 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - T H Beaty
- 1 Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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39
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Akhiwu BI, Efunkoya AA, Akhiwu HO, Adebola RA. Congenital Heart Disease in Cleft Lip and Palate Patients: How Common Is the Association? JOURNAL OF ADVANCED ORAL RESEARCH 2017. [DOI: 10.1177/2229411217729082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Objectives: To determine the prevalence of congenital heart disease in patients with orofacial cleft in a Nigerian population. Materials and Methods: A retrospective review of all the case files of patients with orofacial cleft managed at the Dental and Maxillofacial Surgery unit of the Aminu Kano Teaching Hospital between 2007 and 2014. Data were analyzed using SPSS version 16. Results: A total of 133 patients with cleft lip and palate were seen during the period of study comprising 77 males and 56 females, giving an M:F ratio of 1:0.7. The age range was 15 days–36 years with a mean age of 6 years. There were five cases of congenital heart disease made up of two males and three females, giving a prevalence of 3.76 per cent. Conclusion: This study showed that the prevalence of congenital heart disease in patients with orofacial cleft was low. However, the need for routine echocardiography in all orofacial cleft patients especially children should not be overlooked.
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Affiliation(s)
- Benjamin I. Akhiwu
- Dental and Maxillofacial Surgery Department, Jos University Teaching Hospital/University of Jos (formerly of Aminu Kano Teaching Hospital, Kano)
| | | | - Helen O. Akhiwu
- Department of Paediatrics, Jos University Teaching Hospital, Kano (formerly of Aminu Kano Teaching Hospital, Kano)
| | - Rafael A. Adebola
- Dental and Maxillofacial Surgery Department, Aminu Kano Teaching Hospital, Kano
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40
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Stewart BT, Carlson L, Hatcher KW, Sengupta A, Vander Burg R. Estimate of Unmet Need for Cleft Lip and/or Palate Surgery in India. JAMA FACIAL PLAST SU 2017; 18:354-61. [PMID: 27281157 DOI: 10.1001/jamafacial.2016.0474] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE The unmet need for cleft lip and/or palate (CL/P) care in India is significant. However, estimates required for CL/P care program planning are lacking. OBJECTIVE To estimate the unmet need for CL/P surgery in India at the state level. DESIGN, SETTING, AND PARTICIPANTS To determine the proportion of individuals with CL/P who presented for care in India, data were used from patients who received care at Operation Smile programs in 12 low- and middle-income countries from June 1, 2013, to May 31, 2014. The resulting model describes the prevalent unmet need for cleft surgery in India by state and includes patients older than the surgery target ages of 1 and 2 years for cleft lip and cleft palate repair, respectively. Next, the total number of unrepaired CL/P cases in each state was estimated using state-level economic and health system indicators. MAIN OUTCOMES AND MEASURES Prevalent unmet need for CL/P repair. RESULTS In the 28 states with available data, an estimated 72 637 cases of unrepaired CL/P (uncertainty interval, 58 644-97 870 cases) were detected. The percentage of individuals with unrepaired CL/P who were older than the respective target ages ranged from 37.0% (95% CI, 30.6%-43.8%) in Goa to 65.8% (95% CI, 60.3%-70.9%) in Bihar (median, 57.9%; interquartile range, 52.6%-63.4%). The rate of unrepaired CL/Ps ranged from less than 3.5 per 100 000 population in Kerala and Goa to 10.9 per 100 000 population in Bihar (median rate, 5.9 [interquartile range, 4.6-7.3] per 100 000 population). CONCLUSIONS AND RELEVANCE An estimated 72 000 cases of unrepaired CL/P are found in India. Poor states with less health care infrastructure have exceptionally high rates (eg, Bihar). These estimates are useful for informing international and national CL/P care strategies, allocating resources, and advocating for individuals and families affected by CL/P more broadly. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Barclay T Stewart
- Department of Surgery, University of Washington, Seattle2School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana3Department of Interdisciplinary Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Lucas Carlson
- Harvard Affiliated Emergency Medicine Residency, Brigham & Women's Hospital, Boston, Massachusetts
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41
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Nagalo K, Ouédraogo I, Laberge JM, Caouette-Laberge L, Turgeon J. Congenital malformations and medical conditions associated with orofacial clefts in children in Burkina Faso. BMC Pediatr 2017; 17:72. [PMID: 28292285 PMCID: PMC5351250 DOI: 10.1186/s12887-017-0833-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/08/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Orofacial clefts are usually isolated cases but can be associated with other congenital malformations that are either recognised or unrecognised syndromes. The reported prevalence and pattern of such associated malformations, however, vary among studies. OBJECTIVES To assess the frequencies and aetiologies of congenital malformations and associated medical conditions in children with orofacial clefts in Burkina Faso (Western Africa). METHODS A retrospective descriptive study was carried out at the El Fateh-Suka Clinic in Ouagadougou, Burkina Faso. All children who attended surgery for the repair of a cleft lip and/or palate were included in this study. RESULTS The frequency of congenital malformations associated with cleft lip and/or palate was 39/185 (21.1%). In the group with multiple congenital malformations of unknown origin (34 patients; 18.4%), 66.7% had cleft lip and palate, followed by isolated cleft lip (27.4%) and isolated cleft palate (5.9%). The digestive system (35.3%), the musculoskeletal system (19.6%), and eye, ear, face, and neck (15.7%) were the most affected systems. In the group of syndromic malformations (five patients; 2.7%), amniotic band syndrome (one patient), Van der Woode syndrome (one patient), Goltz syndrome (one patient), and holoprosencephaly (two patients) were identified. Medical conditions included anaemia (39.4%), infections (9.2%), malnutrition (7.5%), and haemoglobinopathies (4.3%). CONCLUSIONS Congenital malformations and medical co-morbidities were frequent in children with OFCs. Further studies and a National Malformations Registry are needed to improve the comprehension of OFCs in Burkina Faso.
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Affiliation(s)
- Kisito Nagalo
- Service of Paediatrics, El Fateh-Suka Clinic, Ouagadougou, Burkina Faso
- UFR/SDS, University of Ouagadougou, Ouagadougou, Burkina Faso
| | - Isso Ouédraogo
- UFR/SDS, University of Ouagadougou, Ouagadougou, Burkina Faso
- Service of Paediatric Surgery, Charles De Gaulle Pediatric University Teaching Hospital, Ouagadougou, Burkina Faso
| | - Jean-Martin Laberge
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Paediatric Surgery, The Montreal Children’s Hospital, McGill University, Montreal, Canada
| | - Louise Caouette-Laberge
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Surgery, St Justine University Teaching Hospital, University of Montreal, Montreal, Canada
| | - Jean Turgeon
- ”Mission Sourires d’Afrique”, Montréal, Canada
- Department of Paediatrics, St Justine University Teaching Hospital, University of Montreal, Montreal, Canada
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42
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Beaty TH, Marazita ML, Leslie EJ. Genetic factors influencing risk to orofacial clefts: today's challenges and tomorrow's opportunities. F1000Res 2016; 5:2800. [PMID: 27990279 PMCID: PMC5133690 DOI: 10.12688/f1000research.9503.1] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2016] [Indexed: 12/18/2022] Open
Abstract
Orofacial clefts include cleft lip (CL), cleft palate (CP), and cleft lip and palate (CLP), which combined represent the largest group of craniofacial malformations in humans with an overall prevalence of one per 1,000 live births. Each of these birth defects shows strong familial aggregation, suggesting a major genetic component to their etiology. Genetic studies of orofacial clefts extend back centuries, but it has proven difficult to define any single etiologic mechanism because many genes appear to influence risk. Both linkage and association studies have identified several genes influencing risk, but these differ across families and across populations. Genome-wide association studies have identified almost two dozen different genes achieving genome-wide significance, and there are broad classes of 'causal genes' for orofacial clefts: a few genes strongly associated with risk and possibly directly responsible for Mendelian syndromes which include orofacial clefts as a key phenotypic feature of the syndrome, and multiple genes with modest individual effects on risk but capable of disrupting normal craniofacial development under the right circumstances (which may include exposure to environmental risk factors). Genomic sequencing studies are now underway which will no doubt reveal additional genes/regions where variants (sequence and structural) can play a role in controlling risk to orofacial clefts. The real challenge to medicine and public health is twofold: to identify specific genes and other etiologic factors in families with affected members and then to devise effective interventions for these different biological mechanisms controlling risk to complex and heterogeneous birth defects such as orofacial clefts.
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Affiliation(s)
- Terri H Beaty
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Mary L Marazita
- Department of Oral Biology and Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA, 15219, USA
| | - Elizabeth J Leslie
- Department of Oral Biology and Center for Craniofacial and Dental Genetics, University of Pittsburgh, Pittsburgh, PA, 15219, USA
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43
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Kadir A, Mossey PA, Blencowe H, Moorthie S, Lawn JE, Mastroiacovo P, Modell B. Systematic Review and Meta-Analysis of the Birth Prevalence of Orofacial Clefts in Low- and Middle-Income Countries. Cleft Palate Craniofac J 2016; 54:571-581. [PMID: 27440051 DOI: 10.1597/15-221] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In the last comprehensive review of the literature published in 2002, little information on the prevalence of orofacial clefts was available from low- and middle-income countries (LMICs). OBJECTIVE To analyze published data on the birth prevalence of cleft lip and/or palate (CL/P) from LMIC. DESIGN Systematic review of the literature and meta-analysis of data from original papers on the birth prevalence of cleft lip and/or cleft palate (CL/P) in LMICs between 1990 and 2014. Secondary inclusion criteria were developed to analyze lower-quality studies from countries with scarce data. MAIN OUTCOME MEASURE Birth prevalence of undifferentiated CL/P (with or without associated syndrome or other anomaly). RESULTS Twenty-eight studies met strict inclusion criteria. Among 31,475,278 total births, the pooled birth prevalence of undifferentiated CL/P was 1.38 per 1000 births (95% confidence interval [CI]: 1.20 to 1.56). Four studies met criteria for secondary analysis, providing data on 75,627 births, with a pooled prevalence of 0.75 CL/P cases per 1000 births (95% CI: 0.56 to 0.95). Comparison of studies was limited by variable definitions of cases and of the reference population and by inconsistent reporting of outcomes. There is significant heterogeneity in the findings. CONCLUSIONS In LMICs, approximately 1 in every 730 children is born with CL/P. To optimize comparability across settings, future research should use a standard classification system and standard criteria for data collection and presentation. As clefting is associated with deprivation, understanding the true scale, risks, and preventive measures for orofacial clefts in LMIC is a matter of both scientific and humanitarian importance.
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Gowans LJJ, Adeyemo WL, Eshete M, Mossey PA, Busch T, Aregbesola B, Donkor P, Arthur FKN, Bello SA, Martinez A, Li M, Augustine-Akpan EA, Deressa W, Twumasi P, Olutayo J, Deribew M, Agbenorku P, Oti AA, Braimah R, Plange-Rhule G, Gesses M, Obiri-Yeboah S, Oseni GO, Olaitan PB, Abdur-Rahman L, Abate F, Hailu T, Gravem P, Ogunlewe MO, Buxó CJ, Marazita ML, Adeyemo AA, Murray JC, Butali A. Association Studies and Direct DNA Sequencing Implicate Genetic Susceptibility Loci in the Etiology of Nonsyndromic Orofacial Clefts in Sub-Saharan African Populations. J Dent Res 2016; 95:1245-56. [PMID: 27369588 DOI: 10.1177/0022034516657003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Orofacial clefts (OFCs) are congenital dysmorphologies of the human face and oral cavity, with a global incidence of 1 per 700 live births. These anomalies exhibit a multifactorial pattern of inheritance, with genetic and environmental factors both playing crucial roles. Many loci have been implicated in the etiology of nonsyndromic cleft lip with or without cleft palate (NSCL/P) in populations of Asian and European ancestries, through genome-wide association studies and candidate gene studies. However, few populations of African descent have been studied to date. Here, the authors show evidence of an association of some loci with NSCL/P and nonsyndromic cleft palate only (NSCPO) in cohorts from Africa (Ghana, Ethiopia, and Nigeria). The authors genotyped 48 single-nucleotide polymorphisms that were selected from previous genome-wide association studies and candidate gene studies. These markers were successfully genotyped on 701 NSCL/P and 163 NSCPO cases, 1,070 unaffected relatives, and 1,078 unrelated controls. The authors also directly sequenced 7 genes in 184 nonsyndromic OFC (NSOFC) cases and 96 controls from Ghana. Population-specific associations were observed in the case-control analyses of the subpopulations, with West African subpopulations (Ghana and Nigeria) showing a similar pattern of associations. In meta-analyses of the case-control cohort, PAX7 (rs742071, P = 5.10 × 10(-3)), 8q24 (rs987525, P = 1.22 × 10(-3)), and VAX1 (rs7078160, P = 0.04) were nominally associated with NSCL/P, and MSX1 (rs115200552, P = 0.01), TULP4 (rs651333, P = 0.04), CRISPLD2 (rs4783099, P = 0.02), and NOG1 (rs17760296, P = 0.04) were nominally associated with NSCPO. Moreover, 7 loci exhibited evidence of threshold overtransmission in NSOFC cases through the transmission disequilibrium test and through analyses of the family-based association for disease traits. Through DNA sequencing, the authors also identified 2 novel, rare, potentially pathogenic variants (p.Asn323Asp and p.Lys426IlefsTer6) in ARHGAP29 In conclusion, the authors have shown evidence for the association of many loci with NSCL/P and NSCPO. To the best of this knowledge, this study is the first to demonstrate any of these association signals in any African population.
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Affiliation(s)
- L J J Gowans
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Pediatrics, University of Iowa, Iowa City, IA, USA Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - W L Adeyemo
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - M Eshete
- Addis Ababa University, Addis Ababa, Ethiopia
| | - P A Mossey
- Department of Orthodontics, University of Dundee, Dundee, Scotland
| | - T Busch
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - B Aregbesola
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - P Donkor
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - F K N Arthur
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S A Bello
- Department of Oral and Maxillofacial Surgery, State House Hospital, Abuja, Nigeria
| | - A Martinez
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - M Li
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - E A Augustine-Akpan
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - W Deressa
- Addis Ababa University, Addis Ababa, Ethiopia
| | - P Twumasi
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - J Olutayo
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - M Deribew
- Addis Ababa University, Addis Ababa, Ethiopia
| | - P Agbenorku
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - A A Oti
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - R Braimah
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - G Plange-Rhule
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - M Gesses
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - S Obiri-Yeboah
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - G O Oseni
- Department of Burns and Plastic Surgery, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
| | - P B Olaitan
- Department of Burns and Plastic Surgery, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
| | - L Abdur-Rahman
- Division of Pediatric Surgery, Department of Surgery, University of Ilorin, Ilorin, Nigeria
| | - F Abate
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - T Hailu
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - P Gravem
- Haukeland University Hospital Bergen, Bergen, Norway
| | - M O Ogunlewe
- Department of Burns and Plastic Surgery, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
| | - C J Buxó
- School of Dental Medicine, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
| | - M L Marazita
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - A A Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - J C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - A Butali
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
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Burg ML, Chai Y, Yao CA, Magee W, Figueiredo JC. Epidemiology, Etiology, and Treatment of Isolated Cleft Palate. Front Physiol 2016; 7:67. [PMID: 26973535 PMCID: PMC4771933 DOI: 10.3389/fphys.2016.00067] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 02/12/2016] [Indexed: 01/21/2023] Open
Abstract
Isolated cleft palate (CPO) is the rarest form of oral clefting. The incidence of CPO varies substantially by geography from 1.3 to 25.3 per 10,000 live births, with the highest rates in British Columbia, Canada and the lowest rates in Nigeria, Africa. Stratified by ethnicity/race, the highest rates of CPO are observed in non-Hispanic Whites and the lowest in Africans; nevertheless, rates of CPO are consistently higher in females compared to males. Approximately fifty percent of cases born with cleft palate occur as part of a known genetic syndrome or with another malformation (e.g., congenital heart defects) and the other half occur as solitary defects, referred to often as non-syndromic clefts. The etiology of CPO is multifactorial involving genetic and environmental risk factors. Several animal models have yielded insight into the molecular pathways responsible for proper closure of the palate, including the BMP, TGF-β, and SHH signaling pathways. In terms of environmental exposures, only maternal tobacco smoke has been found to be strongly associated with CPO. Some studies have suggested that maternal glucocorticoid exposure may also be important. Clearly, there is a need for larger epidemiologic studies to further investigate both genetic and environmental risk factors and gene-environment interactions. In terms of treatment, there is a need for long-term comprehensive care including surgical, dental and speech pathology. Overall, five main themes emerge as critical in advancing research: (1) monitoring of the occurrence of CPO (capacity building); (2) detailed phenotyping of the severity (biology); (3) understanding of the genetic and environmental risk factors (primary prevention); (4) access to early detection and multidisciplinary treatment (clinical services); and (5) understanding predictors of recurrence and possible interventions among families with a child with CPO (secondary prevention).
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Affiliation(s)
- Madeleine L Burg
- Department of Medicine, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
| | - Yang Chai
- Center for Craniofacial Molecular Biology, Ostrow School of Dentistry, University of Southern California Los Angeles, CA, USA
| | - Caroline A Yao
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA; Division of Plastic and Maxillofacial Surgery, Children's Hospital Los AngelesLos Angeles, CA, USA
| | - William Magee
- Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern CaliforniaLos Angeles, CA, USA; Division of Plastic and Maxillofacial Surgery, Children's Hospital Los AngelesLos Angeles, CA, USA
| | - Jane C Figueiredo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California Los Angeles, CA, USA
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Butali A, Mossey P, Tiffin N, Adeyemo W, Eshete M, Mumena C, Audu R, Onwuamah C, Agbenorku P, Ogunlewe M, Adebola A, Olasoji H, Aregbesola B, Braimah R, Oladugba A, Onah I, Adebiyi E, Olaitan P, Abdur-Rahman L, Adeyemo A. Multidisciplinary approach to genomics research in Africa: the AfriCRAN model. Pan Afr Med J 2015; 21:229. [PMID: 26523171 PMCID: PMC4607986 DOI: 10.11604/pamj.2015.21.229.7380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 07/23/2015] [Indexed: 01/01/2023] Open
Abstract
This article is an outcome of the African Craniofacial Anomalies Research Network (AfriCRAN) Human Hereditary and Health (H3A) grant planning meeting in 2012 in Lagos, Nigeria. It describes the strengths of a multidisciplinary team approach to solving complex genetic traits in the craniofacial region. It also highlights the different components and argues for the composition of similar teams to fast track the discovery of disease genes, diagnostic tools, improved clinical treatment and ultimately prevention of diseases.
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Affiliation(s)
- Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA. U.S.A
| | - Peter Mossey
- Department of Orthodontics, University of Dundee, Scotland. UK
| | - Nikki Tiffin
- South African National Bioinformatics Institute, University of the Western Cape, Private Bag, X17, Bellville 7535, South Africa
| | - Wasiu Adeyemo
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos. Nigeria
| | - Mekonen Eshete
- Department of surgery School of Medicine Faculty of health sciences Addis Ababa University, Addis Ababa. Ethiopia
| | - Chrispinanus Mumena
- Department of Oral and Maxillofacial Surgery, Kigali Health Institute, P.O. Box 3286, Kigali, Rwanda
| | - Rosemary Audu
- Human Virology Laboratory, Nigerian Institute of Medical Research, 6, Edmond Crescent, P.M.B. 2013, Yaba, Lagos, Nigeria
| | - Chika Onwuamah
- Human Virology Laboratory, Nigerian Institute of Medical Research, 6, Edmond Crescent, P.M.B. 2013, Yaba, Lagos, Nigeria
| | - Pius Agbenorku
- Department of Plastic Surgery, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, P.O. Box 448, KNUST, Kumasi, Ghana
| | - Mobolanle Ogunlewe
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Lagos, Lagos. Nigeria
| | - Adetokunbo Adebola
- Department of Oral and Maxillofacial Surgery, Aminu Kano University Teaching Hospital, Kano. Nigeria
| | - Hecto Olasoji
- Department of Oral and Maxillofacial Surgery, University of Maiduguri Teaching Hospital, Maiduguri. Nigeria
| | - Babatunde Aregbesola
- Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile-Ife. Nigeria
| | - Ramat Braimah
- Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University, Ile-Ife. Nigeria
| | | | - Ifeanyichukwu Onah
- Department of Plastic Surgery, National Orthopedic hospital, Enugu. Nigeria
| | - Ezekiel Adebiyi
- Department of Computer and Information Sciences and Covenant University Bioinformatics Research (CUBRe), Covenant University, Ota, Nigeria
| | - Peter Olaitan
- Department of Plastic and Reconstructive Surgery, Ladoke Akintola University Ogbomosho. Nigeria
| | | | - Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, U.S.A
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Ghazali N, Rahman NA, Kannan TP, Jaafar S. Screening of Transforming Growth Factor Beta 3 and Jagged2 Genes in the Malay Population with Nonsyndromic Cleft Lip with or without Cleft Palate. Cleft Palate Craniofac J 2015; 52:e88-94. [DOI: 10.1597/14-024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To determine the prevalence of mutations in transforming growth factor beta 3 (TGFβ3) and Jagged2 genes and their association with nonsyndromic cleft lip with or without cleft palate (CL±P) patients. Design Cross-sectional study on nonsyndromic CL±P and noncleft patients. Setting Reconstructive clinic and outpatient dental clinic, Hospital Universiti Sains Malaysia. Patients Blood samples of 96 nonsyndromic CL±P and 96 noncleft subjects. Main Outcome Measure Prevalence and association of mutations in TGFβ3 and Jagged2 genes with nonsyndromic CL±P. Results Most of the nonsyndromic CL±P patients (53.1%) had left unilateral CLP. There were slightly more females (56.6%) compared with males. The prevalence of the mutations in the TGFβ3 gene was 17.7% (95% confidence interval [CI]: 9.5, 24.5) and in the Jagged2 gene was 12.5% (95% CI: 5.5, 18.5), which was higher compared with the noncleft group. For the TGFβ3 gene, there was no mutation in the coding region in either of the groups. All variants were single nucleotide polymorphisms located within the intronic flanking region. Two variants were identified (g.15812T>G and g.15966A>G) in both nonsyndromic CL±P and noncleft patients. However, the association was not significant ( P > .05). Three variants (g.19779C>T, g.19547G>A, and g.19712C>T) were identified in the Jagged2 gene among nonsyndromic CL±P and noncleft patients. Only g.19712C>T showed a significant association with nonsyndromic CL±P patients ( P = .039). Conclusion g.19712C>T might play a crucial role in the development of cleft lip and palate. To the best of our knowledge, this is the first report of the mutation found within intron 13 of the Jagged2 gene among nonsyndromic CL±P Malay patients.
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Affiliation(s)
- Norliana Ghazali
- Dental Public Health Unit, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | | | - Saidi Jaafar
- Molecular Biology Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
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James A, Oluwatosin B, Njideka G, Babafemi, Benjamin OG, Olufemi D, Leo R, Folorunso I, Phylis, Olusina O. CLEFT PALATE IN HIV-EXPOSED NEWBORNS OF MOTHERS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY. ORAL SURGERY 2014; 7:102-106. [PMID: 25653715 PMCID: PMC4313880 DOI: 10.1111/ors.12117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/02/2014] [Indexed: 11/30/2022]
Abstract
AIMS Cleft lip/palate, though rare, is the commonest head and neck congenital malformation. Both genetic and environmental factors have been implicated in the aetiopathogenesis but the role of in-utero exposure to human immunodeficiency virus (HIV) and highly active antiretroviral therapy (HAART) is still being investigated. This short communication reports the occurrence of cleft palate in three newborns exposed in-utero to HIV and HAART. MATERIAL AND METHODS This is a case series of HIV-exposed newborns observed to have cleft palate among a larger cohort of HIV-exposed and unexposed newborns in a study evaluating the effect of HIV infection and HAART on newborn hearing. The Risk Ratio (RR) was calculated to detect a potential association between in-utero exposure to Efavirenz containing ART and cleft palate. RESULTS Three HIV-exposed newborns with cleft palate were identified during hearing screening performed on 126 HIV-exposed and 121 HIV unexposed newborns. Two had exposure to tenofovir+lamivudine+efavirenz (TDF+3TC+EFV) while the third had exposure to zidovudine+lamivudine+nevirapine (ZDV+3TC+NVP) during the first trimester. There was no statistically significant association between presence of cleft palate and exposure to an EFV containing HAART regimen (p=0.07, RR=10.95 [0.94-126.84]). CONCLUSIONS This communication highlights the possible aetiologic role of HAART in cleft palate, the need for further prospective follow-up studies and establishment of antiretroviral pregnancy, birth and neonatal registries.
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Affiliation(s)
- Ayotunde James
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, Nigeria
| | | | - Georgina Njideka
- Department of Virology, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS)
| | - Babafemi
- Center for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | | | - David Olufemi
- Department of Virology, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS)
| | - Robert Leo
- Center for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Isaac Folorunso
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS)
| | - Phylis
- Department of Immunology & Infectious Diseases, Harvard School of Public Health, Boston, MA, USA
| | - Olusegun Olusina
- Department of Paediatrics, College of Medicine, University of Ibadan, Nigeria ; MEDICAL EDUCATION PARTNERSHIP IN NIGERIA ; PRESIDENT'S EMERGENCY PLAN FOR AIDS RELIEF - AIDS PREVENTION INITIATIVE NIGERIA (PEPFAR-APIN PLUS)
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Community Mobilization and Awareness Creation for Orofacial Cleft Services: A Survey of Nigerian Cleft Service Providers. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:140713. [PMID: 27350971 PMCID: PMC4897578 DOI: 10.1155/2014/140713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/08/2014] [Indexed: 11/17/2022]
Abstract
Background. The opportunity to provide free surgical care for orofacial clefts has opened a new vista and is enhanced by well-informed communities who are aware of the free surgical services available to them. It is the responsibility of cleft care providers to adequately inform these communities via a combination of community mobilization and awareness creation. Methods. This was a nationwide, cross-sectional descriptive study of all orofacial cleft service providers in Nigeria using a structured, self-administered questionnaire. Results. A total of 4648 clefts have been repaired, 50.8% by the ten government-owned and 49.2% by the five nongovernment-owned organizations included in the study. The nongovernment-owned institutions seemed to be more aggressive about community mobilization and awareness creation than government-owned ones, and this was reflected in their patient turnout. Most of the organizations studied would prefer a separate, independent body to handle their awareness campaign. Conclusion. Community mobilization requires skill and dedication and may require formal training or dedicated budgets by government-owned and nongovernment-owned institutions alike. Organizations involved in cleft care provision must take community mobilization and awareness seriously if the largely unmet needs of orofacial cleft patients in Nigeria are to be tackled.
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