Prevalence, pattern and perceptions of cleft lip and cleft palate among children born in two hospitals in Kisoro District, Uganda.

BACKGROUND: Cleft lip with or without cleft palate is one of the most common congenital anomalies that affect the oro-facial region. The aim of the study was to determine the period prevalence, pattern and perceptions of cleft lip and cleft palate in children born between 2005 and 2010 in two hospitals in Kisoro District, Uganda. METHODS: The study involved a retrospective review of medical records of mothers who delivered live babies between January 2005 and December 2010 in Kisoro Hospital and St. Francis Hospital, Mutolere in Kisoro District. Key informant interviews of mothers (n = 20) of the children with cleft lip and/or clip palate and selected medical staff (n = 24) of the two hospitals were carried out. The data were analysed using descriptive statistics. RESULTS: Over the 6 year period, 25,985 mothers delivered live babies in Kisoro Hospital (n = 13,199) and St. Francis Hospital, Mutolere (n = 12,786) with 20 babies having oro-facial clefts. The overall period prevalence of the clefts was 0.77/1,000 live births. Sixty percent (n = 12) of children had combined cleft lip and palate and the same proportion had clefts on the left side of the face. More boys were affected than girls: 13 versus 7. About 45% of mothers were hurt on realizing that they had delivered a child with an oro-facial cleft. Forty percent of mothers indicated that a child with oro-facial cleft was regarded as an outcast. About 91.7% (n = 22) of the medical staff reported that these children were not accepted in their communities. Surgical intervention and psychosocial support were the management modalities advocated for by most respondents. CONCLUSION/RECOMMENDATIONS: The period prevalence of combined cleft lip and palate in two hospitals in Kisoro District was comparable to some findings elsewhere. Cleft lip and cleft palate are a medical and psychosocial problem in Kisoro District that calls for sensitization and counseling of the families and communities of the affected children. The policy makers need to strategically plan for provision of rehabilitation with feeding obturators to facilitate easy feeding to gain weight before surgical intervention of the affected children.

The impact of ebinyo, a form of dental mutilation, on the malocclusion status in Uganda.

INTRODUCTION: The practice of extraction of ebinyo or false teeth is based on the belief that the rubbing of herbs on the gum (in the region of the canine) or the removal of the primary and/or permanent canine tooth buds will lead to the relief of childhood fevers and diarrhoea. The reported prevalence of this practice in Uganda and neighbouring countries is varied. OBJECTIVE: A survey carried out in Kampala to determine the occlusal traits of fourteen-year-old children offered an opportunity to assess the effects of ebinyo (a dental mutilation based on local customs and superstitions) on the occlusal status of the sample population. METHODS: 402 children aged fourteen years were examined according to the criteria of the Federation Dentaire Internationale Commission on Classification and Statistics for Oral Conditions method for measuring occlusal traits (COCSTOC-MOT) proposed by Baume et al. (1973). RESULTS: The most common dental anomaly was teeth missing due to extraction or trauma. Canines (28%) and mandibular first molars (28%) exhibited the highest frequency. Missing canines were four times more common in girls than boys, and three times greater in the maxilla than the mandible. Canines also accounted for 12.8% of the malformed teeth observed in the study. CONCLUSION: The results of this study show that the practice of ebinyo, although carried out early in the life of the child, can impact on the occlusal status in the permanent dentition years later.