Oginni Fadekemi O, Adenekan Anthony T
Department of Oral and Maxillofacial Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
Ann Maxillofac Surg. 2012 Jul;2(2):163-9. doi: 10.4103/2231-0746.101346.
Oro-facial cleft (OFC) remains a prominent health issue in developed and developing countries alike. It is the commonest craniofacial birth defect in humans. Mounting evidence suggest a polygenic, multifactorial and a list of epigenetic events. Primary prevention of OFC is based on recognition of the etiologic and risk factors. While a number of preventive strategies are in place for OFC in most developed countries of the world, the majority of developing countries are distant from achieving this goal for a number of reasons. Notable among these are a huge knowledge and practice gap in the field of genetics and dearth of accurate data. In addition, improper coordination and absenteeism from antenatal care contributed greatly to this set back. With ongoing efforts aimed at determining the genetics of nonsyndromic OFC in developing countries, researches directed at identifying environmental factors should equally be in place. Pending the outcome of these, implicated environmental and attitudinal risk factors in other populations could serve as preventive template in health education and interventions. Since risk factors vary between populations, definitive and effective preventive strategies and models would vary from place to place and from time to time. Frantic effort directed at identifying specific implicated risk factors in developing countries should include developing and keeping comprehensive national perinatal database and centralization of antenatal care protocol. Additionally, active health education at every level and a focus on developing manpower in the field of genetics should be in place. These would be designed and tailored toward identified, proven, and emerging risk factors.
口面部裂隙(OFC)在发达国家和发展中国家仍然是一个突出的健康问题。它是人类最常见的颅面出生缺陷。越来越多的证据表明其具有多基因、多因素以及一系列表观遗传事件。OFC的一级预防基于对病因和风险因素的识别。虽然世界上大多数发达国家针对OFC制定了一些预防策略,但由于多种原因,大多数发展中国家距离实现这一目标还很遥远。其中值得注意的是遗传学领域存在巨大的知识和实践差距以及缺乏准确数据。此外,产前护理的协调不当和缺勤也极大地导致了这一挫折。随着发展中国家不断努力确定非综合征性OFC的遗传学,针对识别环境因素的研究也应同步开展。在这些研究结果出来之前,其他人群中涉及的环境和态度风险因素可作为健康教育和干预的预防模板。由于不同人群的风险因素各不相同,明确且有效的预防策略和模式会因时因地而异。在发展中国家,为识别特定的相关风险因素而做出的积极努力应包括建立和维护全面的国家围产期数据库以及集中产前护理方案。此外,还应在各个层面开展积极的健康教育,并注重培养遗传学领域的人力。这些将根据已确定、已证实和新出现的风险因素进行设计和调整。