Cleft Lip and Palate Care in Nigeria

Abstract

BACKGROUND; The World Health Organisation has recommended the need to standardise cleft care globally. In Europe, the Eurocleft project was a concerted effort to improve on the standards of care for children with cleft lip and palate. Certain recommendations were made that were used to judge the standards of care offered, this eventually led to reorganization of services. Improving on standards of cleft care in Nigeria, would require a starting point, by determining what is currently being offered. Measurement of treatment outcome aims at reporting on the quality of care being offered. Up to date, there has been no Nigerian study that has reported on dentofacial outcomes in children affected with cleft lip and palate. This thesis, for the first time reports on dentofacial outcomes by assessing dental relationships in a selected Nigerian cleft population, it also reports broadly on cleft care services available in the country.METHODS AND DESIGN: The design incorporated two methods of data collection; Semi-structured questionnaires administered to cleft care specialists to extract useful information about cleft care services in Nigeria.; Assessment of post-surgical study models of 18 of 5year old Nigerian children affected with UCLP using two commonly used indices (5 years old and the modified Huddart/Bondeham scales) to determine treatment outcome.RESULTS: Treatment outcome reported in a selected Nigerian cleft population is good and compares favourably with treatment outcome in a European cleft population. The results are reliable with moderate to good inter-examiner and intra-examiner agreement. The main form of treatment offered is surgery, which is sponsored mainly by one charity organisation. Shortcomings in services offered include lack of comprehensive care, such as speech therapy and Ear Nose and Throat services, generally cleft care services offered in the country fall below the WHO expected standards. CONCLUSION: This is a single centre study that has determined treatment outcome of Nigerian children affected with CL/P. Findings are valid and reliable, though limited to a selected population.RECCOMENDATIONS: Intercenter studies are recommended in future, this will allow for comparison as well as the use of a larger sample size.

Date of Award	1 Aug 2016
Original language	English
Awarding Institution	The University of Manchester
Supervisor	William Shaw (Supervisor) & Kevin O'Brien (Supervisor)