| dc.description.abstract | Background: Cleft lip and lor palate is a severe birth defect resulting from improper
migration of the ectomesenchymal tissue. The aetiology of clefting is multifactorial with
environmental and genetic factors being implicated. There is racial heterogeneity in the
pattern of occurrence of cleft lip and lor palate with a paucity of literature regarding
African populations.
Ojective: To determine the pattern of occurrence of cleft lip and! or palate among
Kenyans presenting at selected hospitals for treatment.
Design: A descriptive cross-sectional study.
Settings: Kenyatta National Hospital (KNH) , Moi Referral Hospital(MRH), Nakuru
Provincial Hospital (NPH),. New Nyanza Provincial Hospital(NNPH) and Meru District
Hospital(MDH).
Materials and methods: A convenient sample of 396 subjects was included. All patients
who met the inclusion criteria were included in the study. Data were collected by
examining the subjects and completing a clinical examination form (appendix 1). The
training of assistants included calibration to check inter-examiner variability. A
modification of Veau's and the Kernahan classification systems was used to define the
nature of a cleft(appendix 2). The data were presented in the form of charts and tables.
The results were analyzed using the Statistical Package for Social Sciences (SPSS) 10
(SPSS Inc. Chicago, Illinois, USA). The Chi-square test was used to test for significance
of association among variables.
Results: This study included 396 subjects, among whom 236 were male and 160 female.
The age range was 4 weeks to 54 years (mean= 4.8 ± 6.96SD). The distribution of cleft
lip and palate: cleft lip alone: cleft palate was 5.3: 4.9: 1. The male: female ratio among
cases with cleft lip alone was 1.12: 1, while among those with cleft lip and palate 1.71: 1
and for those with cleft palate alone 2.89: 1. Left-sided cleft lip and I or palate was more
common than the right- sided ones. Syndromes associated with clefts included the Van de
Woude (4), Pierre-Robin Sequence (4), Treacher-Collins (1), Apert's (1), Ectodermal
dysplasia (1) and Down's (1). A hereditary trait was apparent among 67(16.9%) of the
cases.
Discussion: The distribution of the various clefts follows a pattern that is different from
that seen in other areas, however, this pattern closely resembles what has been described
in Nigeria. The semblance of the African studies may have a racial/ geographical basis.
The relatively low proportion of cleft palate may be the result of differential influence by
environmental teratogens. Hereditary traits and syndromic clefts were distributed among
the cases as has been seen in studies elsewhere.
Conclusion: There is considerable variation in the pattern oj cleft lip and lor palate as
seen in this study and those reported elsewhere.
Recommendations: There is need for the introduction of both a national registry for the
documentation of these cases and the initiation of community education programmes on
cleft lip and! or palate. | en |
