An assessment of orofacial clefts in Tanzania

<p>Abstract</p> <p>Background</p> <p>Clefts of the lip (CL), the palate (CP), or both (CLP) are the most common orofacial congenital malformations found among live births, accounting for 65% of all head and neck anomalies. The frequency and pattern of orofacial clefts in different parts of the world and among different human groups varies widely. Generally, populations of Asian or Native American origin have the highest prevalence, while Caucasian populations show intermediate prevalence and African populations the lowest. To date, little is known regarding the epidemiology and pattern of orofacial clefts in Tanzania.</p> <p>Methods</p> <p>A retrospective descriptive study was conducted at Bugando Medical Centre to identify all children with orofacial clefts that attended or were treated during a period of five years. Cleft lip and/or palate records were obtained from patient files in the Hospital's Departments of Surgery, Paediatrics and medical records. Age at presentation, sex, region of origin, type and laterality of the cleft were recorded. In addition, presence of associated congenital anomalies or syndromes was recorded.</p> <p>Results</p> <p>A total of 240 orofacial cleft cases were seen during this period. Isolated cleft lip was the most common cleft type followed closely by cleft lip and palate (CLP). This is a departure from the pattern of clefting reported for Caucasian and Asian populations, where CLP or isolated cleft palate is the most common type. The distribution of clefts by side showed a statistically significant preponderance of the left side (43.7%) (χ²= 92.4, p < 0.001), followed by the right (28.8%) and bilateral sides (18.3%). Patients with isolated cleft palate presented at very early age (mean age 1.00 years, SE 0.56). Associated congenital anomalies were observed in 2.8% of all patients with orofacial clefts, and included neural tube defects, Talipes and persistent ductus arteriosus.</p> <p>Conclusions</p> <p>Unilateral orofacial clefts were significantly more common than bilateral clefts; with the left side being the most common affected side. Most of the other findings did not show marked differences with orofacial cleft distributions in other African populations.</p

Eyelid Injuries: A Nine Year Review Of Management

BACKGROUND: Eyelid injuries are usually associated with injury to the eyeball therefore they are mostly reported along with such injuries. This report is a review of cases of eyelid injuries managed in the Jos University Teaching Hospital (JUTH), Jos Central Nigeria. PATIENT AND METHOD: This is a retrospective study of patients with eyelid injuries that were managed over 9 years. The information obtained from the patient's case notes included demographic data, cause, location and type of injury as well as the object responsible for the injury and modality of treatment. RESULT: Sixty six patients with eyelid lid injuries were managed. Fifty seven were males and 9 were females giving a male: female ratio of 6.3:1. The age ranged from one year to 62 years with a mean of 24.8 ± 13.4 years. Thirty percent of the patients were within the third decade of life. There were 36 (54.5%) cases of laceration, 20 (30.3%) cases of abrasions/bruises and 7 (10.6%) cases of avulsions. Road traffic accidents were responsible for most of the injury (27.3%) followed by fights/assault (21.2%) and sports/recreation activities (18.4%). The most frequent objects associated with the injuries were metals (41.0%), fist/feet (13.6%), stone (12.1), and wood (10.6%). There were more injuries to the upper eyelid, while eyeball trauma was the most common associated injury. Twenty three (34.9%) patients who were managed conservatively had no need for suturing or reconstruction. Flaps were used for reconstruction in three (4.5%) patients while direct closure was undertaken in forty (60.6%) patients where such closure will not impair eyelid function. CONCLUSION: Eyelid injury can occur with or without extensive trauma to the eyeball. The upper eyelid is commonly affected and complex reconstruction may be required in cases with extensive injury. KEYWORDS: Eyelid injury, causative factor, repair, reconstruction Nigerian Journal of Orthopaedics and Trauma Vol.3(2) 2004: 118-12