Orofacial clefts in Brazil and surgical rehabilitation under the Brazilian National Health System

Giselle Firmino Torres De Sousa,Angelo Giuseppe Roncalli

doi:10.1590/1807-3107bor-2017.vol31.0023

Giselle Firmino Torres De Sousa, Angelo Giuseppe Roncalli

Open Access

https://doi.org/10.1590/1807-3107bor-2017.vol31.0023

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Abstract

The objective of this study was to investigate the prevalence of live births with orofacial clefts in Brazil from 2009 to 2013, according to Brazil's federative units and regions, and correlate it with the number of corrective surgery procedures for cleft lip and palate performed through the Brazilian National Health System in the same period. The data were collected from the National Live Birth System (SINASC in Portuguese) and the Hospital Information System (SIH-SUS in Portuguese). The results showed that the average prevalence of oral clefts in the period was 5.86 per 10,000 live births, with differences observed between the federative units and the regions. The correlation between the prevalence of orofacial clefts and the number of medical procedures associated with this anomaly was statistically significant (r=0.94; p <0.001). This result indicates that greater investments are being made in areas with a higher number of cases. The relationship between supply and demand for corrective surgeries suggests that only 18.91% of the live births with orofacial clefts in this period may have received this service under the Brazilian National Health System.

Highlights

Orofacial clefts (OFCs), including cleft lip (CL), cleft palate (CP), and cleft lip and palate (CLP), are the most common birth defects in the craniofacial region
An ecological study was conducted to evaluate the occurrence of orofacial clefts in Brazil, and the relationship of this malformation with the number of hospital authorization forms approved for cleft lip and/or palate treatment under the Brazilian National Health System
According to SINASC data from January 2009 to December 2013, 14,446,425 children were born alive in Brazil, among which 7,642 had some type of orofacial cleft

Summary

Introduction

Orofacial clefts (OFCs), including cleft lip (CL), cleft palate (CP), and cleft lip and palate (CLP), are the most common birth defects in the craniofacial region. They may be found isolated or as part of a syndrome.[1] Their etiology is complex and involves several genetic and environmental factors.[2] The prevalence of this malformation varies according to geographic region, ethnic and racial group, environmental exposure and socioeconomic status, and may range between 1:700 and 1:2500 live births.[1,3]. In addition to aesthetic deformation, orofacial cleft patients may experience significant functional changes, which include maxillofacial growth restriction, dental alterations, disturbances in speech, swallowing and feeding difficulties, recurrent ear infections and hearing loss.[4,5,6,7] These changes affect the health and quality of life of individuals with orofacial clefts and their families.[8]

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