Orofacial clefts at Bugando Medical Centre: associated factors and postsurgical complications.

OBJECTIVE: To determine factors associated with orofacial clefts and postsurgical complications of cleft lip and palate repair surgeries in northwestern Tanzania.
METHODS: This was a cohort study involving patients with orofacial clefts. Associated factors (family history of orofacial clefts, maternal use of alcohol and cigarette smoking during pregnancy) were obtained through interviews with accompanying parents. Antenatal cards were used to obtain maternal age at birth and birth weight.
RESULTS: Ninety-four patients with different orofacial clefts were seen. Among them, 46.8% (44/94), 13.8% (13/94), and 39.4% (37/94) had cleft lip, cleft palate, and cleft lip and palate, respectively. About 15% of orofacial cleft cases had a positive family history of orofacial clefts. Among these, 7.4% had an affected relative on the maternal side, 4.3% had an affected relative on the paternal side, and 3.2% had an affected sibling. This difference was statistically significant (chi-square  =  27.7, p < .001). Orofacial cleft was significantly associated with order of birth (chi-square  =  21.0, p < .001). Postoperative complications observed included palatal fistula and philtrum dehiscence.
CONCLUSION: Family history of orofacial clefts and order of birth were significantly associated with orofacial clefts in northwestern Tanzania. These factors have been associated with risk of orofacial clefts elsewhere and suggest a hereditary role in the etiology of orofacial cleft. Palatal fistula and philtrum dehiscence were postsurgical complications observed in orofacial clefts patients who had primary surgery past the recommended age. These complications could have resulted from delayed surgery and absence of presurgical procedures.