The Panorama of Cleft Lip and Palate Live Birth in Brazil: Follow-up of a 10-Year Period and Inequalities in the Health System

2021 ◽  
pp. 105566562110500
Author(s):  
Raquel S. Silva ◽  
Soraia Macari ◽  
Thiago R. dos Santos ◽  
Marcos A.F. Werneck ◽  
Rafaela da Silveira Pinto

Objective To provide the prevalence and an overview of cleft lip and palate (CL/P) in the period of 2008 to 2017, as well as the profile of care provided for this condition in Brazil. Design Cross-sectional study of epidemiological character. Setting Brazilian government website. Participants National Live Birth and Hospital Information System. Intervention Organization of the end databases and performance-based statistical analysis. Main Outcome Measure(s) Analysis of the prevalence of CL/P in newborns, sociodemographic condition of the mothers, surgical procedures and hospitalizations, and specialized hospitals in Brazil within a 10-year period. Results The average prevalence of CL/P in Brazil was ∼52 children per 100 000 live births in the covered period, corresponding to 1 per 1924 newborns. The presence of cleft was associated with preterm birth, being underweight, and the male gender. The highest prevalence was found in the South region, while the lowest was found in the Northeast region, with increasing rates in the North region of Brazil. The states with the highest prevalence were not those with a great number of hospitalizations and surgical procedures for live births with CL/P. Conclusion In the 10-year study period, the prevalence of CL/P was 0.52 newborns per 1000 live births, a result which differs among the states of Brazil. The need to reinforce the national monitoring of the prevalence and surgical procedures of cleft patients have also emphasized the need to improve public medical care for CL/P subjects.

2019 ◽  
Vol 57 (5) ◽  
pp. 552-559 ◽  
Author(s):  
Rengifo Reina Herney Alonso ◽  
Guarnizo Peralta Stefany Brigetty

Objective: To analyze the population prevalence and birth prevalence of oral clefts in Colombia from 2009 to 2017. Methods: A cross-sectional study using information from the National Administrative Records of Colombia. The data came from 2 types of administrative records (Surveillance System and the Individual Registry of Service Provision) and the oral health national survey. Population prevalence and birth prevalence by type of cleft lip and/or cleft (CL/P) ratios were calculated using Poisson distribution for count data and to assess stationary tests on time series (Dickey-Fuller) and (Phillips-Perron) was used. Results: Population prevalence in Colombia was 3.27 per 10 000 inhabitants (95% confidence interval [CI], 3.21-3.32) and birth prevalence was 6.0 per 10 000 live births (95% CI, 5.67-6.35). Bogotá have the highest population prevalence with CL/P. In the analysis of trends for the prevalence proportion by type of clefts in newborn babies with cleft, it was observed that the highest proportion was for babies with CLP. Cleft lip (CL) has increased from 17.4% in 2014 to 34.2% in 2017, cleft palate (CP) has decreased from 32.9% to 20.2%; and CLP changed from 49.6% to 45.5% in the same period. Conclusions: The population prevalence was 3.27 per 10 000 inhabitants. Births prevalence was 6.0 per 10 000 live births, and Orinoquia and Amazonia have higher rates than the national average. The administrative registers are adequate systems to know the behavior of oral clefts. The CL/P had a nonstationary trend during the period 2014 to 2017.


Cureus ◽  
2021 ◽  
Author(s):  
Sravya Turlapati ◽  
Sai Krishna ◽  
Korutla U Deepak ◽  
Baggialaxmi Kanagaraja ◽  
Kanaparthi A Gayathri ◽  
...  

Revista CEFAC ◽  
2021 ◽  
Vol 23 (4) ◽  
Author(s):  
Gabriela Ribeiro Schilling ◽  
Maria Cristina de Almeida Freitas Cardoso ◽  
Paulo Sérgio Gonçalves da Silva ◽  
Marcia Angélica Peter Maahs

ABSTRACT Purpose: to describe the changes in speech and dental occlusion in children with cleft lip and palate and verify their association with each other and with the time of primary plastic surgeries. Methods: a cross-sectional study with collected data on the subjects’ identification, age at the time of primary surgeries, and clinical assessment of speech and dental occlusion. The chi-square test, Fisher's exact test, and t-test were used to verify the associations between the variables at the 5% significance level (p < 0.05). Results: the sample comprised 11 children aged 6 to 10 years, most of whom were males, self-reported white, with trans-incisive foramen cleft, predominantly on the left side. The mean age at lip repair surgery was 6 months, and 13 months at palatoplasty. Among the main dental occlusion changes, posterior and anterior crossbite stood out. All the subjects presented changed speech, with a prevalence of cases with dentoalveolar and palatine deformities, followed by passive and active changes. Subjects with anterior crossbite tended to have undergone primary lip repair surgery at a mean of four months earlier than the subjects without anterior crossbite. Conclusions: the associations between speech and dental occlusion changes, and between these and the time of primary plastic surgeries were not statistically significant. Even though it is known that early lip repair surgery is ideal to favor oral functions and aesthetics, the results revealed a tendency towards anterior crossbite, in these subjects.


2013 ◽  
Vol 4 (3) ◽  
pp. 86-91
Author(s):  
Chai Siew Cheng ◽  
SKL Jimeno ◽  
R Sasidaran ◽  
A Sergius

Objective: To identify number of cases and the type of cleft lip and/or palate managed in government tertiary center (Queen Elizabeth Hospital) in Kota Kinabalu; and to analyze the associative factors of cleft lip and/or palate. Methods: A retrospective cross-sectional study carried out in Hospital Queen Elizabeth, Kota Kinabalu, Sabah from January 2011 to December 2012. Data from 162 new cases, which were referred for cleft lip and/or palate, were included in the study. Result: Cleft lip and palate was the most common type. While cleft lip with or without palate had higher preponderance towards male patients, secondary palate however was more common among female patients. These results were statistically significant. Conclusion: Further and larger scale study need to be carried out to identify the incidence of cleft lip and/or palate in Sabah, and its associated genetic and environmental risk factors. Early identification and intervention for cleft lip and palate need to be emphasized. DOI: http://dx.doi.org/10.3126/ajms.v4i3.8170   Asian Journal of Medical Sciences 4(2013) 86-91


2020 ◽  
pp. 105566562095998
Author(s):  
Sukhraj S. Grewal ◽  
Sirisha Ponduri ◽  
Sam D. Leary ◽  
Yvonne Wren ◽  
John M. D. Thompson ◽  
...  

Objective: This study evaluated association between functional outcomes in children born with unilateral cleft lip and palate (UCLP) and educational attainment. Design: Cleft Care UK (CCUK) was a United Kingdom (UK) wide cross-sectional study. Setting: UK Cleft Teams (data collected from all UK sites providing centralized cleft services). Patients, Participants: Five-year olds born with nonsyndromic UCLP (n = 268). Main Outcome Measure(s): National tests for educational attainment Key Stage 1 (KS1) undertaken by children at age 7 were linked to CCUK data to describe differences in educational attainment. Associations between functional outcomes and KS1 results were evaluated using regression analysis. We adjusted for birth month, gender, and an area-based measure of socioeconomic status. Results: Data were available for 205 children with UCLP. These children scored lower than national average (NA) scores across all subject areas, with a 0.62 lower score observed in the Average Point Score (APS; P = .01). There was association between being in a lower category for a cleft related outcomes and poorer KS1 results, with a trend for poorer attainment with higher numbers of poor functional outcomes. Those with 3 or more poor outcomes had a −2.26 (−3.55 to −0.97) lower APS compared to those with 0 to 1 poor outcomes. Conclusions: Children born with UCLP have poorer educational attainment at age 7 across all subject areas though differences were modest. Children with poor functional outcomes at age 5 had worse educational outcomes age 7. Improvements in functional outcomes could enhance educational outcomes.


Author(s):  
Si-Wei Ma ◽  
Li Lu ◽  
Ting-Ting Zhang ◽  
Dan-Tong Zhao ◽  
Bin-Ting Yang ◽  
...  

Background: Vocabulary skills in infants with cleft lip and/or palate (CL/P) are related to various factors. They remain underexplored among Mandarin-speaking infants with CL/P. This study identified receptive and expressive vocabulary skills among Mandarin-speaking infants with unrepaired CL/P prior to cleft palate surgery and their associated factors. Methods: This is a cross-sectional study involving patients at the Cleft Lip and Palate Center of the Stomatological Hospital of Xi’an Jiaotong University between July 2017 and December 2018. The Putonghua Communicative Development Inventories-Short Form (PCDI-SF) was used to assess early vocabulary skills. Results: A total of 134 children aged 9–16 months prior to cleft palate surgery were included in the study. The prevalences of delays in receptive and expressive vocabulary skills were 72.39% (95% CI: 64.00–79.76%) and 85.07% (95% CI: 77.89–90.64%), respectively. Multiple logistic regression identified that children aged 11–13 months (OR = 6.46, 95% CI: 1.76–23.76) and 14–16 months (OR = 24.32, 95% CI: 3.86–153.05), and those with hard/soft cleft palate and soft cleft palate (HSCP/SCP) (OR = 5.63, 95% CI: 1.02–31.01) were more likely to be delayed in receptive vocabulary skills. Conclusions: Delays in vocabulary skills were common among Mandarin-speaking CL/P infants, and age was positively associated with impaired and lagging vocabulary skills. The findings suggest the necessity and importance of early and effective identification of CL/P, and early intervention programs and effective treatment are recommended for Chinese CL/P infants.


Author(s):  
Manoel Itaguacy Leite NOVAIS JUNIOR ◽  
Manuella Santos Carneiro ALMEIDA ◽  
Camila Helena Machado da COSTA ◽  
Tassia Cristina de Almeida Pinto SARMENTO ◽  
Luis Ferreira de SOUSA FILHO ◽  
...  

ABSTRACT Objective: Evaluating the development of the permanent cuspids in children from Paraíba with cleft lip and palate applying the Nolla and the Demirjian methods. Methods: A cross-sectional study using an inductive approach and applying a comparative statistical procedure and direct documentation research technique. The universe of the study consisted of children assisted at the orthodontic practice of the Brazilian Association of Dentistry - Paraíba Section. The sample comprised 72 pairs of panoramic radiographs of children with and without cleft lip and palate from the same gender and, age difference of up to 30 days, ranging from 5 to 13 years of age. The study has evaluated the development of 576 cuspids. The images were evaluated by three duly calibrated examiners concomitantly, and the calcification stages were determined by a consensus. The stages of the cuspids calcification were evaluated in the panoramic radiographs according to Nolla and Demirjian classifications. Results: The average of the calcification stage of teeth was correspondingly higher in the control group than in the case group, showing a development delay of the cuspid teeth in the cleft lip and palate patients. The lower cuspids were significantly more developed than the upper cuspids (p <0.001). There were no significant differences between the sides. There was early tooth development in females but without significant difference. Conclusion: It was possible to note that patients with cleft lip and palate presented a delay in the development of the permanent cuspids when compared to non-cleft lip and palate patients, thus, reinforcing the importance of the individualization of the orthodontic planning.


2019 ◽  
Vol 57 (1) ◽  
pp. 5-13
Author(s):  
Arthur S. Yang ◽  
Bruce M. Richard ◽  
Andrew K. Wills ◽  
Osama Mahmoud ◽  
Jonathan R. Sandy ◽  
...  

Objectives: To (1) determine the prevalence of nonperialveolar palatal fistula up to age 5 following repair of unilateral cleft lip and palate (UCLP) in the United Kingdom, (2) examine the association of palatoplasty techniques with fistula occurrence, and (3) describe the frequency of fistula repairs and their success. Design: Cross-sectional study. Setting: All 11 centralized regional cleft centers in the United Kingdom. Participants: Two hundred sixty-eight children born between 2005 and 2007 recruited by Cleft Care UK, a nationwide cross-sectional study of all 5-year-old children born with nonsyndromic UCLP. Main Outcome Measure: Nonperialveolar palatal fistula prevalence up to age 5. Results: Fistulas were found in 72 children (31.3%, 95% confidence interval: 25.4%-37.7%) and had no significant association with palate repair sequences. Twenty-four fistulas were repaired by age 5, 12 of which had data showing 10 (83.3%) successful repairs. Conclusion: The prevalence of nonperialveolar fistulas following primary palatoplasty of UCLP in the United Kingdom was higher than previously reported. This information should be part of the preoperative discussion with families. Prospective collection of the presence of fistulas will be necessary before we can associate the occurrence of fistulas with a surgeon, institution, surgical technique, or protocol of care.


2020 ◽  
Vol 4 (3) ◽  
pp. 805-808
Author(s):  
Ajay Singh Thapa ◽  
Rajesh Kumar Yadav

Introduction: Cleft lip and palate is one of the most common congenital malformations. Different syndromes have been described in association with cleft lip and palate, some of which have considerable anesthetic implications, and many involve potential airway problems. Objective: This study aimed to find the incidence of airway complications during cleft surgeries. Methods: The descriptive cross sectional study was conducted in College of Medical Sciences and Teaching Hospital, Bharatpur, Chitwan, Nepal over a period of one year from March 2017 toFebruary2018. All the 146 patients received general anesthesia. The parameters studied were incidence of difficult mask ventilation, difficult intubation, laryngospasm, bronchospasm, aspiration of blood and secretion. Univariate analysis of demographic and occurrence of complications was done. Results: A total of 146 patients underwent cleft surgery over the study duration out of which 42(28.76%) were female and 104(71.23%) were male. Isolated cleft lip was seen in 104 (71.23%)  patients among whom 42 (28.76%) had right sided, 50 (34.24%) had left sided and 12 (8.21%) had bilateral cleft lip. Isolated cleft palate was seen in 12 (8.21%) patients. Combined cleft lip and palate was seen in 30 (20.54%) patients. Prevalence of difficult mask ventilation, difficult laryngoscopy, difficult intubation, incidence of bleeding during intubation, bronchospasm and post extubationlaryngospasmwere4 (2.73%), 11 (7.53%), 6 (4.10%), 2 (1.36%), 2(1.36%) and 4(2.73%). Conclusion: In cleft repair surgeries, difficult laryngoscopic view is the most common problem followed by difficult intubation and difficult mask ventilation. Complications like laryngospasm, bronchospasm and laryngoscopy related bleeding are not uncommon. Vigilant perioperative preparation and continuous monitoring is essential to prevent complications during cleft repair surgery in paediatric patients.


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