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Eleje GU, Okoh EE, Igbodike EP, Akinsolu FT, Nwaokorie FO, Lusher JM, Tantawi ME, Salako AO, Ezechi OC, Foláyan MNO. Prevalence and associated risk factors for noma in Nigerian children: a systematic review and meta-analysis. BMC Oral Health 2024; 24:685. [PMID: 38867180 PMCID: PMC11170919 DOI: 10.1186/s12903-024-04451-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVES To determine the prevalence, case-fatality rate, and associated risk-factors of Noma in children in Nigeria. METHODS Search was conducted in PubMed, Google Scholar, and Cochrane Library databases. Data were extraction using a double-blind approach. Discrepancies were resolved by a third reviewer. Heterogeneity was evaluated using I2 statistics. Random-effects model was used for the meta-analysis and subgroup analysis was conducted. The study quality was evaluated using standard Critical-Appraisal-Checklist. RESULTS Of the 1652 articles identified, 12 studies that met the inclusion criteria included 871 cases of Noma. Two studies had high-risk of bias and were excluded in the meta-analysis. Pooled prevalence of Noma was 2.95% (95%CI:2.19-3.71; Z = 7.60; p < 0.00001, I2:100.0). Case fatality was reported in one study. Sex-distribution had a male-to-female ratio of 1.1:1. Malnutrition (88.42%, 95%CI:52.84-124.00; I2:100.0), measles (40.60%; 95% CI:31.56-49.65; I2:100.0) and malaria (30.75%; 95% CI:30.06-31.45; I2:100.0) were the most notable associated risk-factors. Prevalence of Noma was non-significantly lower in southern (1.96%,95%CI:1.49-2.44;6 studies) than in northern (4.43%; 95%CI:-0.98-9.83; 4 studies) Nigeria. One study reported the prevalence of Noma in children younger than 5 years. CONCLUSIONS About every 3 in 100 children in Nigeria had Noma and the prevalence was non-significantly higher in northern than southern Nigeria. Malnutrition, measles, and malaria were major associated risk-factors. Case-fatality rate and prevalence based on different age-groups were inconclusive.
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Affiliation(s)
- George Uchenna Eleje
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria.
- Effective Care Research Unit, Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka (Nnewi Campus), P.M.B. 5001, Nnewi, Anambra State, Nigeria.
| | - Emeka Emmanuel Okoh
- Department of Community Medicine and Primary Healthcare, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria
| | - Emeka Philip Igbodike
- Department of Obstetrics and Gynaecology, Havana Specialist Hospital, Surulere Lagos, Nigeria
- Department of Obstetrics and Gynaecology, Advanced Minimal Access Surgical Hospital, Kelina Hospital, Victoria Island, Lagos, Nigeria
| | - Folahanmi Tomiwa Akinsolu
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Department of Public Health, Faculty of Medicine, Lead City University, Ibadan, Nigeria
| | - Francisca Obiageri Nwaokorie
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Department of Medical Laboratory Science, University of Lagos, Lagos, Nigeria
| | - Joanne Marie Lusher
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Provost's Group, Regent's University London, London, UK
| | - Maha El Tantawi
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, 21527, Egypt
| | - Abideen Olurotimi Salako
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Department of Public Health, Faculty of Medicine, Lead City University, Ibadan, Nigeria
| | - Oliver Chukwujekwu Ezechi
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Department of Public Health, Faculty of Medicine, Lead City University, Ibadan, Nigeria
| | - Morẹ Nikẹ Oluwátóyìn Foláyan
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
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Gebretsadik HG, Abera Y. High burden of noma in the Gambella region of Ethiopia: a 12-year retrospective study on noma cases from the Facing Africa database. Trans R Soc Trop Med Hyg 2024:trae015. [PMID: 38591224 DOI: 10.1093/trstmh/trae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/13/2023] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Noma, an infectious disease, mainly affects impoverished children. This study retrospectively assessed noma's prevalence in Ethiopia using data from the Facing Africa database and the 2022 United Nations Development Programme poverty index report. METHODS A thorough review of medical records spanning 2007 to 2019 identified a total of 235 noma cases. A standardized data extraction template was employed to systematically gather pertinent clinical and demographic data for subsequent analysis. Prevalence rates were calculated nationally and regionally for both the general population and children aged ≤10 y. RESULTS The analysis revealed estimated national prevalence rates of 0.65 per 100 000 individuals at risk and 1.9 per 100 000 children aged <10 y at risk. The Gambela region exhibited the highest prevalence rate (11.2 per 100 000), whereas the Benshangul Gumuz region had the lowest (0.25 per 100 000). Similar patterns were observed among children aged ≤10 y, with the Gambela and Benshangul Gumuz regions reporting rates of 32.9 and 0.74 per 100 000, respectively. CONCLUSIONS The study highlights noma's significant impact on children aged <10 y in Ethiopia, especially in the Gambella region. It offers crucial baseline data to assist public health professionals, policymakers and healthcare providers in formulating evidence-based strategies to combat noma and improve affected individuals' well-being.
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Affiliation(s)
| | - Yenigat Abera
- Department of Global Health, School of Global Health & Bioethics, Euclid University, Banjul, Gambia
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Baratti-Mayer D, Jeannot E, Dupuis M. Implementation and Evaluation of a Training Program for Traditional Healers to Improve Knowledge of Noma (Cancrum Oris) in Burkina Faso. Am J Trop Med Hyg 2024; 110:303-310. [PMID: 38150738 PMCID: PMC10859805 DOI: 10.4269/ajtmh.23-0407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/06/2023] [Indexed: 12/29/2023] Open
Abstract
Noma (cancrum oris) is an orofacial gangrene affecting young children living in extreme poverty. The acute morbidity is high, and survivors suffer from physical and social sequelae. When diagnosed early, noma can be cured. Noma is especially prevalent in sub-Saharan Africa, where traditional medicine is the norm. The aim of this work was to provide 1-day training to traditional healers in Burkina Faso and to evaluate change in knowledge of noma across time. A sample of 78 healers who attended the training were asked to complete the same questionnaire before, immediately after, and 8 months after the training. A total of 66 healers completed the entire study. Before training, more than 40% of the participants did not know any of its key messages. Most of the key messages were acquired and still present after 8 months by a large proportion of the participants. Systematic intraoral examination was practiced by 7 (9.0%) of the traditional healers before training, and 43 (65.2%) reported doing so 8 months after training. The key messages aiming to improve early diagnosis as well as rapid and adequate treatment (the recognition of facilitating factors and the need to perform a systematic oral examination and to advise hospital transfer) have been well integrated. The study suggests that organizing a self-managed training program is feasible when done within an association, as was the case here, and owing to the willingness to collaborate shown by the traditional healers who participated in our study.
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Affiliation(s)
- Denise Baratti-Mayer
- Service de santé de l’enfance et de la jeunesse, Département de l’instruction publique, de la formation et de la jeunesse, Geneva, Switzerland
- Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Emilien Jeannot
- Institute of Global Health, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Service of Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marc Dupuis
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Gebretsadik HG. Surgical Procedures, Complications, and Durations in Patients with Noma Disease: A Cross-sectional Study. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5496. [PMID: 38115840 PMCID: PMC10730030 DOI: 10.1097/gox.0000000000005496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/02/2023] [Indexed: 12/21/2023]
Abstract
Background Noma is a devastating disease that causes severe destruction of facial tissue, necessitating comprehensive surgical intervention for functional restoration and improved quality of life. This cross-sectional study aimed to identify common surgical procedures used for noma defect reconstruction in Ethiopia, analyze their durations, and assess associated complications. Methods The study retrospectively analyzed noma patient records from Facing Africa's database, covering electronic medical data from 2007 to 2019, and utilized SPSS version 2020 for analysis. Results Facing Africa treated 235 noma cases (2007-2019) with 438 procedures. The most commonly used surgical technique was reconstructive surgery, which encompassed two or more other surgical methods and was used in 177 cases. This was followed by the submental flap in 47 cases and ankylosis release in 35 cases. The study also found complications in 11 cases, including flap necrosis, abscesses, and ankylosis-related mouth restriction. Additionally, the analysis of 102 noma cases revealed significant variations in the duration of surgical procedures, ranging from 10 to 48 hours for specific cases, with the majority (63.7%) requiring 2 to 5 hours. The mean duration of noma surgery was calculated to be 4.08 hours. Conclusions Comprehending common surgical techniques, complications, and durations benefits surgical planning, resource allocation, and patient care. Thus, the results of this study are a useful contribution to the development of effective noma treatment. However, further research and continuous efforts are needed to refine surgical practices, address potential complications, and enhance patient care in the battle against this devastating disease.
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Affiliation(s)
- Heron G. Gebretsadik
- From the Department of Global Health, School of Global Health & Bioethics, Euclid University, Banjul, Gambia
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Saal-Zapata G, Visconti-Lopez FJ. Worldwide Research Trends on Transvenous Embolization of Brain Arteriovenous Malformations: A Bibliometric and Visualized Study. World Neurosurg 2023; 178:20-27. [PMID: 37393998 DOI: 10.1016/j.wneu.2023.06.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 06/25/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Transvenous embolization (TVE) of brain arteriovenous malformations (bAVMs) is an emerging endovascular technique that has shown high cure rates in selected cases. The rationale of our study was to determine authorship and worldwide institutional trends and contributions to the knowledge in this topic. METHODS Web of Science database was used. A total of 63 articles were included based on predefined inclusion criteria, which were manually reviewed. The bibliometric analysis involved the use of quantitative bibliometric indicators and network analysis with co-authorship and co-occurrence of terms, which were performed using the bibliometrix package in R and VOSviewer, respectively. RESULTS The first article was published in 2010, with the largest number of articles published in 2022 (10 articles). The average number of citations per document was 11.38, and the annual growth rate was 14.35%. The top 10 authors with the most scientific production on TVE of bAVMs were from France, and the most cited study was published by Iosif C in 2015, followed by Consoli A in 2013, and Chen CJ in 2018. Journal of Neurointerventional Surgery was the journal with the most articles published. The most commonly used keywords were dural arteriovenous fistula, Onyx, vascular disorders, and neurological surgery around 2016, and intervention around 2021. CONCLUSIONS TVE of bAVMs is an emerging technique. Our search identified some scientific articles, without randomized clinical trials, but many case series from single institutions. French and German institutions are the pioneers in the field, and further research is required in specialized endovascular centers.
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Affiliation(s)
- Giancarlo Saal-Zapata
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, La Victoria, Lima, Peru; Department of Interventional Neurosurgery, Clínica Angloamericana, San Isidro, Lima, Peru
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Visconti-Lopez FJ, Saal-Zapata G. Global Research Trends of Neurosurgery: A Comprehensive Bibliometric and Visualized Analysis of Systematic Reviews. World Neurosurg 2023; 176:e345-e356. [PMID: 37244520 DOI: 10.1016/j.wneu.2023.05.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE This study aimed to determine the bibliometric characteristics of scientific articles on systematic reviews of neurosurgery worldwide. METHODS Bibliographic searches were performed in journals indexed by the Web of Science database until 2022, with no language restrictions. A total of 771 articles were ultimately included on the basis of predefined inclusion criteria, which were manually reviewed. The bibliometric analysis involved the use of quantitative bibliometric indicators and network analysis, which were performed using the bibliometrix package in R and VOSviewer, respectively. RESULTS The first publication was in 2002, and the number of publications increased over time, with the largest number of publications in 2021 (156 articles). The average number of citations per document was 17.36, and the annual growth rate was 6.82%. Nathan A. Shlobin was the author with the most published articles (19 articles). The most cited study was published by Jobst BC (2015). WORLD NEUROSURGERY was the journal with the most publications (51 articles). The country of corresponding authors with the most publications and the greatest number of total citations was the United States. The affiliations with the most articles were University of Toronto (67 articles) and Harvard Medical School (54 articles). CONCLUSIONS The increasing trend during the past 20 years, and especially in the past 2 years, highlights the advancements in various subspecialities in the field. Our analysis revealed that North American and Western European countries are at the forefront of the field. There is a poor output of publications, authors, and affiliations in Latin-American and African countries.
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Affiliation(s)
| | - Giancarlo Saal-Zapata
- Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen-EsSalud, Lima, Lima, Peru; Department of Interventional Neurosurgery, Clinica Angloamericana, Lima, Peru
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