Epidemiological Patterns and Geospatial Mapping of Cleft Lip/Palate in a Comprehensive Cleft Center in Northwestern Nigeria: Estimating Distribution Using Geographical Information Systems.

Abstract

Objective: This study aims to estimate the geospatial distribution of cleft lip/palate (CL/P) cases in northwestern Nigeria and to estimate the prevalence and patterns of CL/P across wards.

Design: This retrospective study utilized information from health records for inpatients with CL/P. These data were analyzed via descriptive statistics. Spatial mapping involves geocoding street addresses into map coordinate system before aggregation for subsequent spatial analyses.

Setting: The center used was a nongovernmental organization clinic that manages CL/P.

Participants: All patients managed during the study period under 15 years were selected for the study, while the spatial analysis included all patients with valid addresses.

Results: A total of 1556 cases were selected, while spatial analyses mapped 928 cases. The analysis indicated over half (54.4%, n = 505 patients) lived in Kano Metropolis, whereas 45.6% (n = 423 patients) lived outside the Metropolis. CL/P prevalence correlated with the population density pattern in Kano. The prevalence of clefts was highest in Metropolis in 2008, and the Metropolis had the highest prevalence of clefts for children under 5 years of age. The significant patient and maternal factors were age (P < .001), weight (P < .001), socioeconomic status (P < .003), positive family history of cleft (P < .001), and maternal factors.

Conclusion: The GIS analysis revealed that most patients with CL/P who received treatment at the NGO lived nearby, with the greatest prevalence of clefts occurring in the Metropolis. The cost of travel may explain why those further afield do not come in for treatment or lack public awareness about the services provided at the cleft clinic.