Patterns of Cleft Lip and Palate in Patients Seen at Four Selected Referral Hospitals in Kenya

Background: Cleft lip (CL) and cleft palate (CP) are among the most common congenital malformations of the craniofacial region, with an incidence of 1 in every 700 newborns worldwide. This global incidence varies across populations due to genetic, environmental, geographic and socioeconomic reasons. These malformations are a result of the failure of fusion of facial processes during embryogenesis and require long-term care from different specialties. However, data on their patterns in Kenya and the region are limited and variable, making the development of national policy guidelines for the management of these clefts more challenging. This study aimed to describe the patterns of cleft lip and cleft palate and the clinical characteristics of affected patients at four selected referral hospitals in Kenya. Methods: This was a hospital-based descriptive cross-sectional study conducted at four selected referral hospitals in Kenya. All patients who met the inclusion criteria and provided consent during the study period were recruited. Variables collected included gender of the patient, age of the patient and parent, type of cleft lip and cleft palate deformities, and associated malocclusion. Data were analyzed using SPSS 26^th Version. Results: A total of 306 participants were recruited into the study. 175 (57.2%) of the participants were male, while 131 (42.8%) were female giving a male-to-female ratio of 1.3:1. Regarding family history, 55 (18.0%) had family history of similar condition. A combination of cleft lip and cleft palate was observed in 153 (50.0%) of the patients, cleft lip alone in 131 (42.8%), while only 22 (7.2%) had isolated cleft palate. On location of the clefts, 131 (46.1%) of the cases were on the left, 81 (28.5%) were on the right, 64 (22.5%) were bilateral while 8 (2.8%) were median. A majority, 149 (84.7%), of the type of CLP and CP were complete, and 27 (15.3%) were incomplete. The prevalence of dental malocclusion was 79.2% in a subset of 24 cases of the study population. Syndromic clefts accounted for 12 (3.9%) of the total number of cleft cases. Conclusion: Combined cleft lip and palate were the most common types of clefts in this study. A male predominance was observed, and left-sided clefts were the most common, consistent with findings reported from other populations. There was a high burden of malocclusions, underscoring the need for changes in policy to address them. Isolated cleft palate cases appeared to present late to the health centers. These findings highlight the urgent need for