Predictors of Delayed Cleft Lip and Palate Surgery: A Case-Control Study in Addis Ababa, Ethiopia.
- 1From the Department of Surgery, Plastic and Reconstructive Surgery Unit, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- 2Department of Internal Medicine, Saint Paul's Millennium Medical College, College of Medicine and Health Sciences, Addis Ababa, Ethiopia.
Abstract
Background
Orofacial clefts are common anomalies, and timely treatment is essential for optimal outcomes. In low- and middle-income countries, surgical delays are frequent, yet contributing factors remain understudied. This study aims to identify and quantify these factors at a tertiary medical center in Ethiopia.Methods
An institution-based unmatched case-control study was conducted among 98 patients between January 2023 and December 2024. Cases included patients undergoing surgery after the recommended age (cleft lip >6 mo; cleft palate >12 mo), whereas controls received timely surgery. Data were collected from medical records and telephone interviews. Bivariate analysis and multivariate logistic regression were performed to determine predictors.Results
Isolated cleft palate (adjusted odds ratio = 21.72; 95% confidence interval [CI], 4.17-113.12; P < 0.001) and greater distance to a cleft center (per kilometer increase: odds ratio = 1.012; 95% CI, 1.003-1.021; P = 0.007) were significantly associated with delayed treatment. Lack of formal education of caregivers showed a strong borderline association (adjusted odds ratio = 8.61; 95% CI, 0.68-108.89; P = 0.096). Post-hoc power exceeded 99.9%. The final model demonstrated good performance, with an area under the receiver operating characteristic curve of 0.875 and acceptable fit (Hosmer-Lemeshow χ² = 11.037; degrees of freedom = 8; P = 0.200).Conclusions
Cleft type and geographic barriers were the primary determinants of delayed surgery. Patients with isolated cleft palate and those residing farther from specialized centers had higher odds of delayed treatment. Interventions should focus on improving early detection, referral pathways, and access to cleft care.
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BibTeX
@article{dawit2026predictors,
title = {{Predictors of Delayed Cleft Lip and Palate Surgery: A Case-Control Study in Addis Ababa, Ethiopia.}},
author = {Anteneh M Dawit and Mekonen A Eshete and Getaw A Gebeyehu and Dagim K Minasie},
journal = {Plastic and reconstructive surgery. Global open},
year = {2026},
month = oct,
doi = {10.1097/gox.0000000000008187},
url = {https://europepmc.org/article/MED/42903290},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Predictors of Delayed Cleft Lip and Palate Surgery: A Case-Control Study in Addis Ababa, Ethiopia.
AU - Anteneh M Dawit
AU - Mekonen A Eshete
AU - Getaw A Gebeyehu
AU - Dagim K Minasie
PY - 2026
DA - 2026/10/20
JO - Plastic and reconstructive surgery. Global open
DO - 10.1097/gox.0000000000008187
UR - https://europepmc.org/article/MED/42903290
AB - Background Orofacial clefts are common anomalies, and timely treatment is essential for optimal outcomes. In low- and middle-income countries, surgical delays are frequent, yet contributing factors remain understudied. This study aims to identify and quantify these factors at a tertiary medical center in Ethiopia.Methods An institution-based unmatched case-control study was conducted among 98 patients between January 2023 and December 2024. Cases included patients undergoing surgery after the recommended age (cleft lip >6 mo; cleft palate >12 mo), whereas controls received timely surgery. Data were collected from medical records and telephone interviews. Bivariate analysis and multivariate logistic regression were performed to determine predictors.Results Isolated cleft palate (adjusted odds ratio = 21.72; 95% confidence interval [CI], 4.17-113.12; P < 0.001) and greater distance to a cleft center (per kilometer increase: odds ratio = 1.012; 95% CI, 1.003-1.021; P = 0.007) were significantly associated with delayed treatment. Lack of formal education of caregivers showed a strong borderline association (adjusted odds ratio = 8.61; 95% CI, 0.68-108.89; P = 0.096). Post-hoc power exceeded 99.9%. The final model demonstrated good performance, with an area under the receiver operating characteristic curve of 0.875 and acceptable fit (Hosmer-Lemeshow χ² = 11.037; degrees of freedom = 8; P = 0.200).Conclusions Cleft type and geographic barriers were the primary determinants of delayed surgery. Patients with isolated cleft palate and those residing farther from specialized centers had higher odds of delayed treatment. Interventions should focus on improving early detection, referral pathways, and access to cleft care.
SN - 2169-7574
ER -