Epidemiology of Clefts in Kwazulu Natal: Comparison With Systematic Review Analysis, Similarities, and Differences

The incidence and accuracy of cleft epidemiology is variable depending on geographical region, population group, and country being assessed. Confounding factors are rendered more accurate if consecutive patients seen in a unit over a prolonged period are reported.

Plastic surgery charts at Inkosi Albert Luthuli Central Hospital (IALCH) were reviewed from 2003 to 2019. Appropriate International Classification of Diseases (ICD) cleft codes were used to obtain a cleft database of all cleft patients. The review revealed 1487 cleft patients. Data extracted included sex, race, extent of cleft lip or palate, laterality, and birth month.

Overall, there was an almost equivalent sex distribution with 745 females and 742 males. There were 390 cleft lip only (26%), 505 cleft lip with palate (CLP) (34%), and 592 cleft palate only (40%). In the cleft lip only group, Black females were affected in 54% and males in 46%, whereas in the Asian group, females were affected in 33% and males in 67% ( P =0.022). In the CLP group, Asian and Colored females were affected more (56% and 60%, respectively), while in the Black and White groups, females were less affected (40% and 26%, respectively). Cleft palate only was the most common category in Black (44%) and Colored (55%), while the CLP category was most common in Asian (49%) and White (42%).

Demographics of cleft lip and palate in KwaZulu Natal is different from other series in certain aspects. In addition, there are differences in the race groups when analyzing certain aspects. The differences may be based on genetic or environmental factors and warrants further investigation.