Cleft Lip with or without palate in seven countries with two income levels: a cross-sectional study.
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Alamoudi Rana A, Abudawood Shahad N, Abdulhameed Fatma Dawood, Alnamnakani Eman Abdulbaset, Rabah Sari M, Hamdan Mustafa A, Alhamlan Nasir H, Zeinalddin Mohammad, Al-Batayneh Ola B, Al Bulushi Taimoor, AboulHassan Mamdouh A, Koraitim Mohamed, Alkharafi Lateefa, Almuqbali Buthaina, Alghamdi Sultan Musaad, Refahee Shaimaa Mohsen, Quritum Maryam, Taqi Fatemah Fahad, Albassam Bader, Ayed Mariam, Embaireeg Alia, Alnahdi Raqiya, Senguttuvan Viswapurna, AlSharif Mona Talal, Aljohar Aziza Johar, Alrejaye Najla Sulaiman, Al Halasa Tamara, Basri Osama Adel, Albatayneh Mohammad A, Almalik Manal Ibrahim, Alhussain Reema Mahdi, Khan Muhammad Asjad, Yousaf Muhammad Abrar, AlZabin Alya, Kasem Albadani Mohammed Sadeq, Almajed Ebtesam, Albrahim Razan A, Aldawish Reema A, Alyahiwi Lara S, Alshabnan Rand A, Odeh Ruba M, Khader Yousef S, Sabbagh Heba Jafar
Аннотация
METHODOLOGY: A cross-sectional, multicountry-study was carried out in seven Middle Eastern and Asian countries (high income: Saudi Arabia, Kuwait, Oman, UAE; lower-middle income: Egypt, Pakistan, Jordan) at major government and university cleft care referral centers. Cleft phenotypes were classified using the LASHAL system, and severity was categorized into seven grades, ranging from unilateral incomplete CL (mild) to bilateral complete CLP (severe).
RESULTS: There were 836 CL/P patients; out of them, 337(40.3%) were CL, 499(59.7%) were CLP and 160 (19.1%) diagnosed with associated anomalies. A subgroup analysis demonstrated a significant relationship between country economic level and CL/P severity (P < 0.001), with lower-middle-income countries showing higher rates of unilateral-incomplete-CL and high-income countries presenting more bilateral-complete-CLP. Associated anomalies occurred significantly more among unilateral complete CL cases (P = 0.036). Regression analysis found that low-to-moderate income countries significantly decreased the adjusted odds ratio (AOR) of CLP compared to CL phenotypes (AOR: 0.494, P = 0.032), and having mild compared to severe CL/P (AOR = 0.431, P = 0.029).
CONCLUSION: This multicenter study revealed that the socioeconomic level influences both cleft type and severity. Collaborative research focusing on genetic, environmental, and healthcare access factors is recommended to better explain the socioeconomic variations observed and guide targeted prevention and policy strategies.