Prevalence and associated risk factors for noma in Nigerian children: a systematic review and meta-analysis

• Main Authors: George Uchenna Eleje (Author), Emeka Emmanuel Okoh (Author), Emeka Philip Igbodike (Author), Folahanmi Tomiwa Akinsolu (Author), Francisca Obiageri Nwaokorie (Author), Joanne Marie Lusher (Author), Maha El Tantawi (Author), Abideen Olurotimi Salako (Author), Oliver Chukwujekwu Ezechi (Author), Morẹ́nikẹ́ Oluwátóyìn Foláyan (Author)
• Format: Book
• Published: BMC, 2024-06-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

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.

Item Description

10.1186/s12903-024-04451-y
1472-6831