Anthropometric nutrition outcomes of children under 5 years undergoing cleft palate repair at CoRSU rehabilitation hospital Uganda; trends, patterns and determinants


  • Joseph Mbuga Department of Plastic, Reconstructive and Cosmetic Surgery, CoRSU Rehabilitation Hospital, Kisubi, Entebbe, Uganda
  • George William Galiwango Department of Plastic, Reconstructive and Cosmetic Surgery, CoRSU Rehabilitation Hospital, Kisubi, Entebbe, Uganda
  • Martin Tungotyo Department of Plastic, Reconstructive and Cosmetic Surgery, CoRSU Rehabilitation Hospital, Kisubi, Entebbe, Uganda



Cleft palate, Underweight, Wasting, Stunting


Background: Objective of the study was to assess the prevalence and determinants of postoperative malnutrition and compare the preoperative and postoperative trends and patterns of malnutrition among children under 5 years undergoing cleft palate repair at CoRSU rehabilitation hospital in Uganda.

Methods: A cross-sectional analytical study done between March 2018 and March 2019 at CoRSU rehabilitation hospital; a tertiary rehabilitation hospital offering free comprehensive cleft care to patients from Uganda and beyond. We consecutively enrolled 115 non-syndromic children under 5 years who had undergone complete cleft palate repair at CoRSU hospital at least 3 months previously. Children’s anthropometric parameters; weight for age Z score, height for age Z score and weight for height Z score were obtained and compared at initial, preoperative and postoperative visits.

Results: The prevalence of wasting was 53.0% versus 12.7% versus 4.4% that of stunting was 44.4% versus 41.7% versus 48.7% that of underweight was 57.4% versus 34.8% versus 15.7% while that of overweight was 0.0% versus 5.2% versus 9.6% at initial, preoperative and postoperative visits respectively. Postoperative stunting was independently associated with age groups 12-23 months (p=0.013) and 24-59 months (p=0.006), residing in Eastern (p=0.021) and Western (p=0.033) regions and being stunted (p=0.000) or wasted (p=0.028) preoperatively.

Conclusions: Postoperatively, the prevalence of both wasting and underweight reduced by 10- and 3- fold respectively; prevalence of stunting remained critically high while that of overweight increased nearly 10-fold. Surgery improves the nutrition status of children with cleft palate.



Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organiz. 2005;83:661-9.

Mossey P, Little J. Addressing the challenges of cleft lip and palate research in India. Ind J Plastic Surg. 2009;42(Suppl):9.

Mossey PA, Catilla EE. Global registry and database on craniofacial anomalies: Report of a WHO Registry Meeting on Craniofacial Anomalies. 2003.

Shaw W. Global strategies to reduce the health care burden of craniofacial anomalies: report of WHO meetings on international collaborative research on craniofacial anomalies. The Cleft Palate-Craniofacial J. 2004;41(3):238-43.

Dreise M, Galiwango G, Hodges A. Incidence of cleft lip and palate in Uganda. The Cleft Palate-Craniofacial J. 2011;48(2):156-60.

Kalanzi E, Mengiste A, Katamba A. Incidence of cleft deformities among neonates in Mulago National Referral hospital, Uganda. East and Central Afr J Surg. 2013;18(1):78-83.

Isaac N, Choi E. Infant Anatomy and Physiology for Feeding. 2012.

Cubitt J, Hodges A, Galiwango G, Van Lierde K. Malnutrition in cleft lip and palate children in Uganda. Eur J Plastic Surg. 2012;35(4):273-6.

Wilson J, Hodges A. Cleft lip and palate surgery carried out by one team in Uganda: where have all the palates gone? The Cleft Palate-Craniofacial J. 2012;49(3):299-304.

Tungotyo M, Atwine D, Nanjebe D, Hodges A, Situma M. The prevalence and factors associated with malnutrition among infants with cleft palate and/or lip at a hospital in Uganda: a cross-sectional study. BMC Pediatr. 2017;17(1):17.

Katusabe JL, Hodges A, Galiwango GW, Mulogo EM. Challenges to achieving low palatal fistula rates following primary cleft palate repair: experience of an institution in Uganda. BMC Res Notes. 2018;11(1):358.

Shashidhar V, Dhanwadkar SS, NB AK, Kurle R, Navale RA. The prevalence of malnutrition in children with cleft lip and cleft palate: a case-control study. Int J Contemp Pediatr. 2019;6(2):445.

Altaweel AA, Abdelkader A, Mohamed RS. Effect of two-flap palatoplasty on growth and speech in patients with a cleft palate. Tanta Dent J. 2016;13(2):96.

Jane Lee JN, Charlotte Wright. Height and weight achievement in cleft lip and palate. Arch Dis Childhood. 1997;76:70-2.

Popkin BM, Richards MK, Montiero CA. Stunting is associated with overweight in children of four nations that are undergoing the nutrition transition. J Nutr. 1996;126(12):3009-16.

Mamabolo RL, Alberts M, Steyn NP, Delemarre-van de Waal HA, Levitt NS. Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the Central Region of Limpopo Province, South Africa. Public Health Nutr. 2005;8(5):501-8.

De Boo HA, Harding JE. The developmental origins of adult disease (Barker) hypothesis. Australian and New Zealand J Obstetr Gynaecol. 2006;46(1):4-14.

UDHS I. Uganda demographic and health survey. Uganda Bureau of Statistics, Kampala Uganda. 2011.

Victora CG, De Onis M, Hallal PC, Blössner M, Shrimpton R. Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics. 2010;125(3):473-80.

Shrimpton R, Victora CG, de Onis M, Lima RC, Blössner M, Clugston G. Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics. 2001;107(5):75-6.

Leroy JL, Ruel M, Habicht JP, Frongillo EA. Linear growth deficit continues to accumulate beyond the first 1000 days in low-and middle-income countries: global evidence from 51 national surveys. J Nutr. 2014;144(9):1460-6.

Paramashanti BA, Benita S. Early introduction of complementary food and childhood stunting were linked among children aged 6-23 months. J Gizi Klinik Indonesia. 2020;17(1):1-8.

Statistics UBo, ICF. Uganda demographic and health survey 2016: key indicators report. UBOS, and Rockville Maryland. 2017.

Vella V, Tomkins A, Borghesi A, Migliori GB, Adriko B, Crevatin E. Determinants of child nutrition and mortality in north-west Uganda. Bull World Health Organiz. 1992;70(5):637.






Original Research Articles