尼日利亚儿童坏疽性口炎的患病率及相关危险因素：一项系统评价与荟萃分析。

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

作者信息

Eleje George Uchenna, Okoh Emeka Emmanuel, Igbodike Emeka Philip, Akinsolu Folahanmi Tomiwa, Nwaokorie Francisca Obiageri, Lusher Joanne Marie, Tantawi Maha El, Salako Abideen Olurotimi, Ezechi Oliver Chukwujekwu, Foláyan Morẹ́nikẹ́ Oluwátóyìn

机构信息

Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.

Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Nnewi, Nigeria.

出版信息

BMC Oral Health. 2024 Jun 12;24(1):685. doi: 10.1186/s12903-024-04451-y.

DOI:10.1186/s12903-024-04451-y

PMID:38867180

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11170919/

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 I 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, I: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; I:100.0), measles (40.60%; 95% CI:31.56-49.65; I:100.0) and malaria (30.75%; 95% CI:30.06-31.45; I: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.

摘要

目的

确定尼日利亚儿童坏疽性口炎的患病率、病死率及相关危险因素。

方法

在PubMed、谷歌学术和考克兰图书馆数据库中进行检索。采用双盲法提取数据。由第三位审阅者解决分歧。使用I统计量评估异质性。采用随机效应模型进行荟萃分析并进行亚组分析。使用标准的批判性评价清单评估研究质量。

结果

在检索到的1652篇文章中，12项符合纳入标准的研究共纳入871例坏疽性口炎病例。两项研究存在高偏倚风险，在荟萃分析中被排除。坏疽性口炎的合并患病率为2.95%（95%CI：2.19 - 3.71；Z = 7.60；p < 0.00001，I：100.0）。一项研究报告了病死率。性别分布的男女比例为1.1:1。营养不良（88.42%，95%CI：52.84 - 124.00；I：100.0）、麻疹（40.60%；95%CI：31.56 - 49.65；I：100.0）和疟疾（30.75%；95%CI：30.06 - 31.45；I：100.0）是最显著的相关危险因素。坏疽性口炎的患病率在尼日利亚南部（1.96%，95%CI：1.49 - 2.44；6项研究）略低于北部（4.43%；95%CI： - 0.98 - 9.83；4项研究），但差异无统计学意义。一项研究报告了5岁以下儿童坏疽性口炎的患病率。