The Global, Regional, and National Patterns of Change in the Burden of Orofacial Clefts, 1990–2021: An Analysis of the Global Burden of Disease Study 2021 and Forward-Looking Forecast

OBJECTIVE: Orofacial clefts (OFCs) are the most common congenital craniofacial anomalies worldwide. However, data on the burden and trends of this disease remains limited. METHODS: This study utilizes data from the 2021 Global Burden of Disease study to analyze the prevalence, incidence, and disability-adjusted life years from 1990 to 2021 at global, regional, and national levels, along with age-standardized rates and the average annual percentage change. In addition, the authors examine these global trends by age, gender, and Sociodemographic Index (SDI). Frontier analysis was employed to visually illustrate each country's or region's potential to reduce the burden based on its development level. Finally, the authors used the autoregressive integrated moving average model to forecast future trends in disease burden from 2022 to 2036. RESULTS: The study shows that, despite a 24.79% decline in incidence from 1990 to 2021, the global number of OFC cases has increased by 3.96%. The incidence of OFCs varies significantly across regions, with the highest incidence in Central Asia. The OFC burden is negatively correlated with SDI, indicating that higher socio-economic development is associated with a lower disease burden. Gender differences show a slightly higher incidence in males, while age-specific data indicate that the highest burden occurs in the first year of life. This study also identifies countries with the greatest disease burden disparities, particularly in low-income regions such as Afghanistan and Cambodia. Projections indicate a continued decline in global OFC incidence and case numbers from 2022 to 2036. CONCLUSION: The findings highlight the need for targeted interventions, especially in low-income and middle-income countries, to address inequalities in access to health care.