Age at Primary Surgery among Persons Born with Orofacial Clefts in Africa

Mekonen Eshete; Fikre Abate; Abiye Hailu; Awgichew Kifle; Azeez Alade; Tewodros Melese; Getaw Alamne; Getaneh Seyoum; Bethel Mulugeta; Asrat Mengiste; Merertu Temesgen; Erli Sarilita; Peter Mossey; Paul E. Gravem; Azeez Butali

doi:10.1097/SCS.0000000000011889

Age at Primary Surgery among Persons Born with Orofacial Clefts in Africa

Mekonen Eshete (Lead / Corresponding author)
, Fikre Abate
, Abiye Hailu
, Awgichew Kifle
, Azeez Alade
, Tewodros Melese
, Getaw Alamne
, Getaneh Seyoum
, Bethel Mulugeta
, Asrat Mengiste
, Merertu Temesgen
, Erli Sarilita
, Peter Mossey
, Paul E. Gravem
, Azeez Butali

Dentistry

Research output: Contribution to journal › Article › peer-review

Abstract

Orofacial clefts (OFC) are the most common anomalies in the head and neck region, with an overall prevalence of 1 in 700 live births. OFCs can have a lasting, unfavourable effect on the affected individual's health. Timely surgical intervention is critical for optimal outcomes. The age at primary surgery and access to care across African countries remain poorly understood. Objective: The main aim of this study was to assess the age at which primary OFC surgeries are performed in African patients born with OFCs, using data from the Smile Train Express Database (STX). Methods: A retrospective descriptive study of 161,035 patients with OFCs who received primary surgical treatment at Smile Train partner institutions in 40 African countries between January 2004 and December 2023. Data included age at surgery, sex, type of cleft, type of surgery, and country/region of origin. Descriptive analyses were performed using SPSS version 25. Results: It is estimated that 484,640 African children were born with OFCs during the study period; of these, 33.2% received surgical treatment through Smile Train support during the study period. Most patients (78.5%) received cleft lip surgery. 28.8% of patients received timely primary surgery: cleft lip surgery ≤6 months and cleft palate surgery ≤12 months of age. 71.1% of unilateral cleft lip and 74.6% of palate surgeries were performed after the recommended age. Timeliness improved over time, with significant increases in both surgery volume and early intervention rates in the second half of the study period (2014-2023). Conclusion: Despite an increase in cleft surgeries and improvements in timely intervention over the years, the majority of children in Africa still receive delayed surgical care for OFCs. These findings highlight the urgent need for expanded access to early cleft care, improved health system infrastructure, and targeted community education to overcome barriers to timely surgery.

Original language	English
Article number	10.1097/SCS.0000000000011889
Pages (from-to)	e1228-e1233
Journal	Journal of Craniofacial Surgery
Volume	36
Issue number	8
DOIs	https://doi.org/10.1097/SCS.0000000000011889
Publication status	Published - Nov 2025

Keywords

Africa
age
cleft lip and palate

ASJC Scopus subject areas

Surgery
Otorhinolaryngology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1097/SCS.0000000000011889

Cite this

Eshete, M., Abate, F., Hailu, A., Kifle, A., Alade, A., Melese, T., Alamne, G., Seyoum, G., Mulugeta, B., Mengiste, A., Temesgen, M., Sarilita, E., Mossey, P., Gravem, P. E., & Butali, A. (2025). Age at Primary Surgery among Persons Born with Orofacial Clefts in Africa. Journal of Craniofacial Surgery, 36(8), e1228-e1233. Article 10.1097/SCS.0000000000011889. https://doi.org/10.1097/SCS.0000000000011889

@article{024974e246d646e0b9a5fa65b2e617f6,

title = "Age at Primary Surgery among Persons Born with Orofacial Clefts in Africa",

abstract = "Orofacial clefts (OFC) are the most common anomalies in the head and neck region, with an overall prevalence of 1 in 700 live births. OFCs can have a lasting, unfavourable effect on the affected individual's health. Timely surgical intervention is critical for optimal outcomes. The age at primary surgery and access to care across African countries remain poorly understood. Objective: The main aim of this study was to assess the age at which primary OFC surgeries are performed in African patients born with OFCs, using data from the Smile Train Express Database (STX). Methods: A retrospective descriptive study of 161,035 patients with OFCs who received primary surgical treatment at Smile Train partner institutions in 40 African countries between January 2004 and December 2023. Data included age at surgery, sex, type of cleft, type of surgery, and country/region of origin. Descriptive analyses were performed using SPSS version 25. Results: It is estimated that 484,640 African children were born with OFCs during the study period; of these, 33.2\% received surgical treatment through Smile Train support during the study period. Most patients (78.5\%) received cleft lip surgery. 28.8\% of patients received timely primary surgery: cleft lip surgery ≤6 months and cleft palate surgery ≤12 months of age. 71.1\% of unilateral cleft lip and 74.6\% of palate surgeries were performed after the recommended age. Timeliness improved over time, with significant increases in both surgery volume and early intervention rates in the second half of the study period (2014-2023). Conclusion: Despite an increase in cleft surgeries and improvements in timely intervention over the years, the majority of children in Africa still receive delayed surgical care for OFCs. These findings highlight the urgent need for expanded access to early cleft care, improved health system infrastructure, and targeted community education to overcome barriers to timely surgery.",

keywords = "Africa, age, cleft lip and palate",

author = "Mekonen Eshete and Fikre Abate and Abiye Hailu and Awgichew Kifle and Azeez Alade and Tewodros Melese and Getaw Alamne and Getaneh Seyoum and Bethel Mulugeta and Asrat Mengiste and Merertu Temesgen and Erli Sarilita and Peter Mossey and Gravem, \{Paul E.\} and Azeez Butali",

year = "2025",

month = nov,

doi = "10.1097/SCS.0000000000011889",

language = "English",

volume = "36",

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Eshete, M, Abate, F, Hailu, A, Kifle, A, Alade, A, Melese, T, Alamne, G, Seyoum, G, Mulugeta, B, Mengiste, A, Temesgen, M, Sarilita, E, Mossey, P, Gravem, PE & Butali, A 2025, 'Age at Primary Surgery among Persons Born with Orofacial Clefts in Africa', Journal of Craniofacial Surgery, vol. 36, no. 8, 10.1097/SCS.0000000000011889, pp. e1228-e1233. https://doi.org/10.1097/SCS.0000000000011889

TY - JOUR

T1 - Age at Primary Surgery among Persons Born with Orofacial Clefts in Africa

AU - Eshete, Mekonen

AU - Abate, Fikre

AU - Hailu, Abiye

AU - Kifle, Awgichew

AU - Alade, Azeez

AU - Melese, Tewodros

AU - Alamne, Getaw

AU - Seyoum, Getaneh

AU - Mulugeta, Bethel

AU - Mengiste, Asrat

AU - Temesgen, Merertu

AU - Sarilita, Erli

AU - Mossey, Peter

AU - Gravem, Paul E.

AU - Butali, Azeez

PY - 2025/11

Y1 - 2025/11

N2 - Orofacial clefts (OFC) are the most common anomalies in the head and neck region, with an overall prevalence of 1 in 700 live births. OFCs can have a lasting, unfavourable effect on the affected individual's health. Timely surgical intervention is critical for optimal outcomes. The age at primary surgery and access to care across African countries remain poorly understood. Objective: The main aim of this study was to assess the age at which primary OFC surgeries are performed in African patients born with OFCs, using data from the Smile Train Express Database (STX). Methods: A retrospective descriptive study of 161,035 patients with OFCs who received primary surgical treatment at Smile Train partner institutions in 40 African countries between January 2004 and December 2023. Data included age at surgery, sex, type of cleft, type of surgery, and country/region of origin. Descriptive analyses were performed using SPSS version 25. Results: It is estimated that 484,640 African children were born with OFCs during the study period; of these, 33.2% received surgical treatment through Smile Train support during the study period. Most patients (78.5%) received cleft lip surgery. 28.8% of patients received timely primary surgery: cleft lip surgery ≤6 months and cleft palate surgery ≤12 months of age. 71.1% of unilateral cleft lip and 74.6% of palate surgeries were performed after the recommended age. Timeliness improved over time, with significant increases in both surgery volume and early intervention rates in the second half of the study period (2014-2023). Conclusion: Despite an increase in cleft surgeries and improvements in timely intervention over the years, the majority of children in Africa still receive delayed surgical care for OFCs. These findings highlight the urgent need for expanded access to early cleft care, improved health system infrastructure, and targeted community education to overcome barriers to timely surgery.

AB - Orofacial clefts (OFC) are the most common anomalies in the head and neck region, with an overall prevalence of 1 in 700 live births. OFCs can have a lasting, unfavourable effect on the affected individual's health. Timely surgical intervention is critical for optimal outcomes. The age at primary surgery and access to care across African countries remain poorly understood. Objective: The main aim of this study was to assess the age at which primary OFC surgeries are performed in African patients born with OFCs, using data from the Smile Train Express Database (STX). Methods: A retrospective descriptive study of 161,035 patients with OFCs who received primary surgical treatment at Smile Train partner institutions in 40 African countries between January 2004 and December 2023. Data included age at surgery, sex, type of cleft, type of surgery, and country/region of origin. Descriptive analyses were performed using SPSS version 25. Results: It is estimated that 484,640 African children were born with OFCs during the study period; of these, 33.2% received surgical treatment through Smile Train support during the study period. Most patients (78.5%) received cleft lip surgery. 28.8% of patients received timely primary surgery: cleft lip surgery ≤6 months and cleft palate surgery ≤12 months of age. 71.1% of unilateral cleft lip and 74.6% of palate surgeries were performed after the recommended age. Timeliness improved over time, with significant increases in both surgery volume and early intervention rates in the second half of the study period (2014-2023). Conclusion: Despite an increase in cleft surgeries and improvements in timely intervention over the years, the majority of children in Africa still receive delayed surgical care for OFCs. These findings highlight the urgent need for expanded access to early cleft care, improved health system infrastructure, and targeted community education to overcome barriers to timely surgery.

KW - Africa

KW - age

KW - cleft lip and palate

UR - https://www.scopus.com/pages/publications/105014957702

U2 - 10.1097/SCS.0000000000011889

DO - 10.1097/SCS.0000000000011889

M3 - Article

C2 - 40874970

AN - SCOPUS:105014957702

SN - 1049-2275

VL - 36

SP - e1228-e1233

JO - Journal of Craniofacial Surgery

JF - Journal of Craniofacial Surgery

IS - 8

M1 - 10.1097/SCS.0000000000011889

ER -

Age at Primary Surgery among Persons Born with Orofacial Clefts in Africa

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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