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尼日利亚冲突频发地区一家三级医院的坏疽性口炎病例回顾。

A review of noma cases in a tertiary hospital located in a conflict endemic region in Nigeria.

作者信息

Owobu Thomas, Ojukwu Basil Tochukwu, Azah Oba Onisoman, Sulaiman Shehu Adamu, Halilu Muhammed, Nnawuihe Ukachi Chiwendu, Sanni Auwalu Balarabe

机构信息

Department of Dental and Maxillofacial Surgery, Federal Medical Centre, Nguru, Nigeria.

Department of Clinical Services and Public Health, Intercountry Centre for Oral Health for Africa, Jos, Plateau, Nigeria.

出版信息

Med Confl Surviv. 2022 Dec;38(4):295-306. doi: 10.1080/13623699.2022.2114121. Epub 2022 Aug 24.

Abstract

Noma, a neglected tropical disease (NTD), is a preventable oro-facial gangrenous infection causing destruction of oro-facial tissues if untreated. This descriptive study was conducted in North-Eastern Nigeria which has witnessed armed insurgency increasing risk of noma. Data was obtained from patients' records at a tertiary hospital after a dental educational outreach using radio and visits to the hospital's ante/postnatal clinics. Data analysis was conducted at 95% confidence interval with p≤ 0.05 considered significant. Records of 49 patients were retrieved but 31 (63.3%) were utilised due to poor documentation. Age ranged from 2-63 years. Children (0-16 years) and Adults (17-59 years) were 67.7% and 25.8% respectively. Males were 13 (41.9%) and females, 18 (58.1%). Poor oral hygiene and malnutrition were common findings. Stage (WHO Staging System) 2 (51.6%) and 4 (22.6%) were the most common presentation. Successfully managed and referred cases were 51.6% and 48.4% respectively. Successful management was associated with early stages of noma (p = <0.001). Children were most vulnerable. Outreaches using radio and education to pregnant women and nursing mothers can boost early presentation and better outcomes. Attention to case documentation and inclusion of noma into the WHO list of NTDs are recommended.

摘要

坏疽性口炎是一种被忽视的热带病,是一种可预防的口腔面部坏疽性感染,若不治疗会导致口腔面部组织遭到破坏。这项描述性研究在尼日利亚东北部开展,该地区经历了武装叛乱,增加了坏疽性口炎的发病风险。在一次通过广播进行的牙科教育宣传活动以及走访该医院的产前/产后诊所之后,从一家三级医院的患者记录中获取了数据。数据分析在95%置信区间进行,p≤0.05被视为具有显著性。检索到了49名患者的记录,但由于记录不完整,仅使用了31份(63.3%)。年龄范围为2至63岁。儿童(0至16岁)和成人(17至59岁)分别占67.7%和25.8%。男性有13名(41.9%),女性有18名(58.1%)。口腔卫生差和营养不良是常见的情况。(世界卫生组织分期系统)2期(51.6%)和4期(22.6%)是最常见的表现。成功治疗并转诊的病例分别占51.6%和48.4%。成功治疗与坏疽性口炎的早期阶段相关(p = <0.001)。儿童最为脆弱。通过广播进行宣传以及对孕妇和哺乳期母亲开展教育,能够促进早期就诊并取得更好的治疗效果。建议关注病例记录,并将坏疽性口炎列入世界卫生组织的被忽视热带病名单。

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