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Cleft is present at different frequencies in different cultures and races as well as countries. An estimated 45% of the population is non-Caucasian. The U.S. is becoming more of a “melting pot”, as it was once coined (Strauss, 1990) and within this "melting pot" there are people who present with cleft lip and/or palate. Cleft lip and/or palate is a congenital abnormality that is seen frequently around the world. On average, about 1 in every 500-750 live births result in a cleft (Hardin-Jones, Karnell, & Peterson-Falzone, 2001). Furthermore, in the U.S., the prevalence for cleft lip with or without cleft palate (CL +/- P) is 2.2 to 11.7 per 10,000 births. Cleft palate alone (CP) results in a prevalence rate of 5.5 to 6.6 per 10,000 births (Forrester & Merz, 2004). Cleft of the lip, palate, or both is one of the most common congenital abnormalities and has a birth prevalence rate ranging from 1/1000 to 2.69/1000 amongst different parts of the world (McLeod, Saeed, & Arana- Urioste, 2004).
Africans and African Americans A look in to the prevalence rates of different cultures in the U.S. when compared to their country of origin begins with Africans and African Americans. 1 per 2,500 African Americans are born with a cleft (Suleiman, Hamzah, Abusalab, & Samaan, 2005). African Americans have a lower prevalence rate of CL +/- P when compared to Caucasians. A prevalence rate of .61 per 1,000 and 1.05 per 1,000 live births respectively was reported by Croen, Shaw, Wasserman and Tolarova (1998). In Malawi there is a reported low prevalence rate for cleft lip and/or palate, .7 per 1,000 live births (Chisi, Igbibi, & Msamati, 2000). Suleiman et al. (2005) found that the prevalence rate of clefting among a group of Sudanese hospital new-borns in the city of Khartoum is .9 per 1,000 live births.
Latino Americans and Native Latinos Latin Americans come from Mexico, Central America and South America, and the Caribbean (Meyerson, 1990). The prevalence of Latino Americans is lower than that of Caucasians and Native Americans, yet it is still higher than African Americans (Croen et al., 1998). Latinos have a prevalence of clefting of 9.7 per 10,000 live births (Kirby, Petrini & Alter, 2000). In Sucre, Bolivia the prevalence rate of CL +/- P is 1.23 per 1,000 live births (McLeod et al., 2004).
Jordan Al Omari & Al-Omari (2004) reported that no study exists that has specifically looked at clefting among Jordanians prior to their investigation. Al Omari et al. (2004) examined the prevalence of clefting over an eleven-year period in Jordan and found an overall rate of 1.39 per 1,000 live births for CL +/- P. This was found to be similar with the prior studies that have examined clefting in other Arab populations.
United States of America Hawaii is a U.S. state which has an extremely diverse population consisting of 73% people of Asian and Pacific Islander descent. Forrester & Merz (2004) found that the prevalence rates of CL +/- P per 10,000 live births in Hawaii were: 10 in Caucasians, 16 in people of Far East Asian descent, 11 in people of Pacific Islander descent, and 14.5 in people of Filipino descent.When looking at the countries of origin, a higher rate was seen for Asians, specifically in Pakistan, with the prevalence rate being 1.91 per 1,000 live births (Elahi, Jackson, Elahi, Khan, Mubarak, Tariq, & Mitra, 2004). Similarly, C. Oh, S. Kim, W. Kim, & J. Kim (2002) found a similar prevalence rate of 1.81 per 1,000 births in the Republic of Korea. Valid prevalence rates in the native countries of the Philippines and Pacific Islands could not be reported.
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