Ludwig's angina in Nigeria: The disease of the poor and health inequality!

AIM

highlight the health inequality and identify opportunities to improve the care delivered to the patients who suffer from Ludwig's angina which could have national and international clinical impact.

MATERIALS AND METHODS

Data was collected from three major oral and maxillofacial centers, in Nigeria including Benin, Lagos and Kano. A protocol was developed for data collection which included demographic details, socio-economic status, management of the air way, the associated morbidities and mortalities.

RESULTS

Forty-nine were managed in Benin, 57 in Lagos and 66 in Kano. Diabetes was the most prevalent underlying systematic condition, affecting 21% of the Ludwig's angina patients in Lagos. Poverty was a common denominator, 90% of the patients from Kano were unemployed compared to 23% and 8% from Lagos and Benin respectively. For most of the patients, the airway was monitored. Incision and drainage were carried out in most of the cases at Benin and Lagos, but it was only considered in 50% of the cases in Kano. Mortality ranged from 4% in Benin to 12% in Lagos and it was as high as 19% in Kano.

CONCLUSION

poor access to oral healthcare, unemployment and low socio-economic status are important predisposing factors of Ludwig's angina.