Digitizing Incidence of Orofacial Clefts at a Multidisciplinary Orofacial Cleft Center in Ghana

Abstract

Background: Orofacial cleft care in sub-Saharan Africa has historically relied on international collaboration for both patient care and data recording for local research. This study aims to incorporate a digital database into regular practice at a multidisciplinary orofacial cleft clinic. We hope to demonstrate the utility of this method in promoting accessible, indigenous record collection in our program. Methods: A multidisciplinary cleft clinic at the Komfo Anokye Teaching Hospital (KATH) developed a REDcap form to collect demographic and clinical data on new presentations to the orofacial cleft clinic. Data was collected retrospectively between April 2021 and April 2022 and prospectively between May 2022 and April 2023. A basic analysis of incidence data was conducted. Results: A total of 116 new patients with cleft were recorded in the clinic during the study period. The median patient age was 3 weeks and ranged between 1 week and 56 years over the entire cohort. 47.4% of patients were male. Diagnosis included: 59 (52.2%) isolated cleft lip, 31 (27.4%) cleft palate, 23 (20.4%) cleft lip and palate. Cleft lip presented unilaterally in 46 (78%) patients, and was incomplete in 25 (42.4%) cases. The ratio of left versus right unilateral cleft was 1.09 in males versus 2.2 in females, though no significant association between patient sex and cleft lip laterality was noted (P = .08). Conclusions: Our experience incorporating a digital database into a multidisciplinary clinic was positive, with rapid uptake and easy use for both retrospective and prospective data collection. We believe that such approaches are pivotal to continued development of indigenous African orofacial cleft centers and for homegrown outreach efforts. Continued validation of this method will further validate this methodology and improve outreach to the patient base at Komfo Anokye Teaching Hospital.