Abstrak
Professionals involved in the care of patients with clefts in Africa face unique challenges when compared with what obtained in western countries. It is the purpose of this paper to review some of the challenges of cleft care in Africa. A computerized literature search using electronic databases; Ovid MEDLINE, EMBASE and AJOL databases was conducted for published articles from 1965 to 2006. Mesh phrases used in the search were: Cleft lip, Cleft palate, Cleft care, Management, Challenges and Africa. The search produced 46 articles. A critical evaluation of the 46 articles using the inclusion and exclusion criteria led to selection of 20 articles for the review. The findings were: (1) No reliable data on incidence of cleft; (2) Strong traditional beliefs system exist regarding etiology of cleft; (3) Health problems attributed to clefts common at presentation; (4) Patients with cleft commonly present late; (5) Lack of multidisciplinary approach to care. The chance that a child born with a cleft tomorrow in Africa will receive the best care possible can not yet be guaranteed. The need to formulate basic strategies to improve the standard of cleft care in Africa and the rest of the developing world is overdue. We hope that the findings in this review will provoke solutions that might ultimately improve the standard of cleft care in Africa and the rest of the developing world.
Keywords: Craniofacial, cleft, palate, challenges, Africa
Résumé
Les professionnels impliques dans les soins de sante aux patients ayant les fentes en Afrique soufre des défis uniques lorsque comparée avec ceux des pays développés. Le but de cette étude était de revoir certaines défis des soins des fentes en Afrique. Une revue littéraire informatisée sur les banques des données électroniques, Ovid Medline, Embase et AJOL a conduit aux articles entre 1995-2006. les phrases utilisées pour la recherche inclue : lèvre de la fente, soins de la fente, soins, défis en Afrique , produisant 46 articles. Une évaluation critique de ces articles avec des critères d’inclusion et d’exclusion conduisaient a 20 articles seulement.ces résultats inclus (1) pas des données sur l’incidence de la fente, (2) Système de croyance traditionnelle existe sur l’étiologie de la fente, (3)les problèmes de sante attribues a la fente commune a la présentation,(4) patients ayant une présentation tardive, (5) manque d’approche multidisciplinaire aux soins. Le chance qu’un nouveau ne en Afrique ayant la fente recevra des meilleurs soins possibles ne peut pas être garantie. La nécessite de formuler des stratégies de base afin d’améliorer le standard des soins de la fente en Afrique et les autres pays sous développés reste important. Nous espérons que ces résultats provoqueront des solutions qui peuvent ultimement améliorer le standard des soins en Afrique et dans d ;autres pays sous développés.
Correspondence: Dr. H.O. Olasoji, Department of Oral and Maxillofacial Sugery, University of Maiduguri Teaching Hospital, PMB 1414, Maiduguri, Borno State, Nigeria. E-mail: soji273 @yahoo.com
Referensi
World Health Organization. Global strategies to reduce the health burden of craniofacial anomalies: Report of WHO meetings on international collaborative anomalies. Geneva: World Health Organization; 2002 (Human Genetics Programme 2002. Management of noncommunicable diseases). Available from: ttp:/www.who.int/ncd/hgn/publications.htm
Mossey PA and Little I. Epidemiology of oral clefts: an international perspective. In: Wyszynski DF, editor. Cleft lip and palate: from origin to treatment. New York: Oxford University Press: 1992.
Zbar IS, Rai SM and Dingman DL. Establishing cleft malformation surgery in developing nations: a model for the new millennium. Plast Reconstr Surg 2002; 106(4): 886-889.
Olasoji HO, Ukiri AA and Yahaya A. Incidence and etiology of oral clefts: a review. Afr J Med Med Sci 2005; 34(1): 1-7.
Bicker WB and Sanno-Daunda B. Epidemiology of paediatric admissions to a government referral hospital in the Gambia. Bulletin of the World Health Organaisation 2000; 78 (11): 1330-1336.
Iregbulum LM. The incidence of cleft lip and palate in Nigeria. Cleft Palate J 1982; 19: 201-205.
Hook EB. Incidence and prevalence as measures of the frequency of congenital malformation and genetic outcomes: Application to oral clefts. Cleft Pal J 1988; 25: 97-102.
Temtamy SA, Abdel Meguid N, Mazen I, Ismail SR, Kassem and Bassiouni R. A genetic epidemiological study of malformations at birth in Egypt. Eastern Mediterranean Health Journal 1998; 4: 252-259.
Kaimenyi JT. Oral health in Kenya. International Dental Journal 2004; 54: 378-32.
Adeyemo AA, Okolo CM and Omotade OO. Major congenital malformations among paediatric admissions at University College Hospital, Ibadan. Annals of Tropical Paediatrics 1994; 14: 75-79.
Dagher D and Ross E. Approaches of South African traditional healers regarding the treatment of cleft lip and palate. Cleft Palate-craniofac J 2004; 41; 461-471.
Olasoji HO, Ugboko VI and Arotiba GT. Cultural and religious components in Nigerian parent’s perceptions of etiology of cleft lip and palate: Implications in treatment and rehabilitation. Br J Oral Maxillofac Surg. In Press.
Hawkins PJF. Law and the rights of the Disabled child in Lesotho. London: S. O. A. S London University. (1989).
Olasoji HO, Dogo D, Obiano SK and Yawe T. Cleft lip and palate in north eastern Nigeria. Ng Quat J Hosp Med 1997; 7(3): 209-213.
Olasoji HO, Tahir C and Isa A. An unusual bilateral oblique facial cleft in a newborn. Inter J Pead Otorhinlaryn 2005; 69: 999-1001.
Ojofeitimi E and Oyefeso O. Beliefs, attitudes and expectations of mothers concerning handicapped children in Ile-ife, Nigeria. Royal Soc School Health J 1980; 3: 101-104.
Olasoji O, Arotiba T and Dogo D. Experience with unoperated cleft lip and palate patients in a Nigerian n teaching hospital. Trop Doc 2002; 32: 33-36.
Schwarz R and Khadka SB. Reasons for late presentation of cleft deformity in Nepal. Cleft Palate-Craniofac J 2004; 41: 199-201.
Olasoji HO, Adeosun OO and Adesina AO. Socio-economic and cultural background of parents with non-syndromic cleft lip and/or palate children in northern Nigeria. Pakistan Oral and Dent J 2005; 25(2): 139-143.
Hodges AM and Hodges SC. A rural cleft project in Uganda. Br J Plast Surg 2002; 53: 7-11.
Orkar KS, Ugwu BT and Momoh JT. Cleft lip and palate, Jos experience. East Afr Med J 2002; 79: 510-513.
Chancholine AR. Plastic surgery, cleft lip and palate and the third world. Ann Chir Plast Eshtet 2004; 49(3): 236-238.
Donkor P, Benkas DO, Agbenorku P, Plange-Phule G and Ansah SK. Cleft lip and palate surgery in Kumasi, Ghana 2001-2005. J Craniofac Surg 2007; 18: 1376-1379.
Khan AA. Congenital malformation in African neonates. J Trop Med Hyg 1964; 68: 272.
Ogle OE. Incidence of cleft lip and palate in a newborn Zairian sample. Cleft Palate Craniofac J 1993; 30: 250-251.
Salako AA and Daniel OJ. Identifying the training needs of traditional birth attendants. Trop Doct 2007; 37: 6-10.
World Health Organisation. Global Registry and Database on Craniofacial Anomalies Eds: Mossey PA, Castillia (2003). WHO Reports, Human Genetics Programme: International Collaborative Research on Craniofacial Anomalies, WHO publications, Geneva, Switzerland. 2003 (ISBN 92 4 159110 2).
Strauss RP. Culture, rehabilitation and facial defects: international case studies. Cleft Palate J 1985; 1: 56-62.
Reeve ME, Grace NE, Persing JA and Megge SN. An international surgical exchange program for children with cleft lip/cleft palate in manaus, brazil: patients and family expectations of outcome. J Craniofac surg 2004; 1: 170-174.
Rosero A, Bolto LD, Bottling B and Mastroia P. Infant mortality and congenital anomalies from 1950 to 1994: an international perspective. J Epid Community Health 2000; 54: 660-666.
Murray CJ and Lopez AD. Regional patterns of disability-free life expectancy and disability-adjusted life expectancy: global burden of disease study. Lancet 1997; 350 (9071): 144-145.
Singh H and Soni RK. Awareness about infant feeding practices among nursing personnel. Indian J Matern Child Health 1990; 1(3): 5-6.
Shaw WC, Semb G, Nelson P, Bratttstrom V, Molsted K and Prahl-Anderson B, Gundlach KKH. The Eurocleft project 1996-2000: overview. J Cranio-Maxillofac Surg 2001; 29: 131-140.
Strauss PR. The organization and delivery of craniofacial health services: The state of the Art. Cleft Palate-Craniofac J 1999; 36: 189-195.
Dupuis CC. Humanitarian missions in the third world: a polite dissent. Plast Reconstr Surg 2004; 113(1): 433-435.
McGraw-Wall BL and Sykes TM. Cleft surgery in Third world. Facial Plast Surg 1993; 9(3): 213-218.