Ten-year experience of more than 35,000 orofacial clefts in Africa
Ten-year experience of more than 35,000 orofacial clefts in Africa
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DOI：
10.1186/s12887-015-0328-5
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发表时间：
2015-02-14
期刊：
影响因子：
2.4
通讯作者：
Jabs, Ethylin Wang
中科院分区：
文献类型：
--
作者：
Conway, Julia C.;Taub, Peter J.;Jabs, Ethylin Wang
背景：口面裂的手术矫正可以大大减轻不良后果。然而，在发展中国家，接受重建手术的机会有限。本研究回顾了2001- 2011年来自一个慈善组织微笑列车的流行病学数据，以及来自33个非洲国家的手术病例数据库。这些数据被记录在Excel中，使用SPSS进行分析，并与以前报道的data.Results：36,384例患者的389名非洲外科医生完成了问卷。唇腭裂的发生率为34.44%，唇腭裂占58.87%，单纯腭裂占6.69%。男女比例为1.46：1，单侧：双侧比例为2.93：1，左侧优势为1.69：1。在4.18%的患者中发现了相关异常。最常见的手术包括初次唇/鼻修复，单侧（68.36%）和双侧（11.84%）。唇裂出生率有季节性变化，1月最高，12月最低。手术时的平均年龄为9.34岁，在国内生产总值较低的国家有所增加。平均住院时间为4.5天。报告的并发症发生率为1.92%。结论：除腭裂外，结果符合全球流行病学报告的趋势，CL为25%，CLP为50%，CP为25%，单侧：双侧和左侧：右侧比例为2：1，男性占优势。孤立性腭裂的患者，尤其是女性患者，少于预期，这表明经济资源和明显唇畸形的文化美学方面的限制可能超过女性的功能问题和获得治疗的机会。少于预期的相关异常提示真实的种族差异，或更多受影响的患者未接受治疗。由于非洲大陆的多样性和研究设计之间的相当大的差异，非洲口面裂的流行病学一直难以评估。大样本量的数据收集提供了一个基础，为进一步研究的流行病学的口面裂在非洲。
Background: Surgical correction of orofacial clefts greatly mitigates negative outcomes. However, access to reconstructive surgery is limited in developing countries. The present study reviews epidemiological data from a single charitable organization, Smile Train, with a database of surgical cases from 33 African countries from 2001-2011.Methods: Demographic and clinical patient data were collected from questionnaires completed by the participating surgeons. These data were recorded in Excel, analyzed using SPSS and compared with previously reported data.Results: Questionnaires were completed for 36,384 patients by 389 African surgeons. The distribution of clefts was: 34.44% clefts of the lip (CL), 58.87% clefts of the lip and palate (CLP), and 6.69% clefts of the palate only (CP). The male to female ratio was 1.46:1, and the unilateral: bilateral ratio 2.93:1, with left-sided predominance 1.69:1. Associated anomalies were found in 4.18% of patients. The most frequent surgeries included primary lip/nose repairs, unilateral (68.36%) and bilateral (11.84%). There was seasonal variation in the frequency of oral cleft births with the highest in January and lowest by December. The average age at surgery was 9.34 years and increased in countries with lower gross domestic products. The average hospital stay was 4.5 days. The reported complication rate was 1.92%.Conclusions: With the exception of cleft palates, results follow trends of worldwide epidemiologic reports of 25% CL, 50% CLP, and 25% CP, 2:1 unilateral: bilateral and left:right ratios, and male predominance. Fewer than expected patients, especially females, presented with isolated cleft palates, suggesting that limitations in economic resources and cultural aesthetics of the obvious lip deformity may outweigh functional concerns and access to treatment for females. A fewer than expected associated anomalies suggests either true ethnic variation, or that more severely-affected patients are not presenting for treatment. The epidemiology of orofacial clefting in Africa has been difficult to assess due to the diversity of the continent and the considerable variation among study designs. The large sample size of the data collected provides a basis for further study of the epidemiology of orofacial clefting in Africa.