TITLE:
Influencing Factors for Social Acceptance of Noma (Cancrum Oris) Patients in Niger: A Hospital-Based Cross-Sectional Study
AUTHORS:
Abdou Hassane Issa, Kadre Alio Kadre Ousmane, Elhadj Ousmane Hamady Issa, Jiahao Shen, Maiga Djibo Douma, Alkassoum Salifou Ibrahim, Moeng Eva, Ying Guan
KEYWORDS:
Noma, After-Effects, Socio-Psychological Factors, Social Acceptance/Rejection, Social Reintegration
JOURNAL NAME:
Health,
Vol.15 No.4,
April
25,
2023
ABSTRACT: Background: Noma,
mostly identified in malnourished young children in the world’s low-income
countries, causes severe orofacial disfigurement and significant mortality and
morbidity. The majority of noma patients surviving with aesthetical effects are
exposed to stigmatization and social rejection. Studies focusing on the
socio-psychological impact of noma survivors have rarely been done. Our study
aimed to identify the differences in social acceptance/rejection and the
influencing factors associated with social acceptance in noma patients. Methods: A cross-sectional study was conducted at the NGO-Sentinelles (Niger) reception
center on patients with noma from Zinder, Maradi, and Tahoua regions between 9th May 2017 and 2nd June 2017. The survey was conducted through a
face-to-face interview on patients admitted to the center and those discharged
from the centre after the treatment. The interview questionnaire comprised 45
questions (Cronbach’s alpha coefficient = 0.812) with pathological information,
sociodemographic characteristics, and socio-psychological qualitative
information. Findings: We recorded 50 noma patients (43 from Zinder and
7 from Maradi and Tahoua). The younger patients (1 - 5 years old), noma
patients who stayed in school during follow-up treatment, patients who were
referred by a health structure, patients enrolled into the centre in a short
time (χ2 =
45.536, (P s ranging from 0.609 to 0.810, moderately correlated with patient’s
sociodemographic characteristics (age, marital status, and region) with rs ranging from 0.381 to 0.474. Lowly correlated with clinical evolution after
treatment (rs = 0.293). Logistic regression results showed that the
likelihood of social acceptance increased when the patient’s age was young (≤15
years), their marital status was minor, they were enrolled at the school before
noma appearance, they were referred to the centre after diagnosis, the
admission time to the centre was short (≤30 days), acute phase of noma, and
care received at the centre was non-surgery. The location of the lesion on the
cheek was a risk factor for social acceptance, indicating cheek lesions from
noma increased the likelihood of social rejection in our study. Conclusion: The sociodemographic characteristics, pathological history, and psychological
aspects of noma patients were correlated and were found to be important factors
influencing their social acceptance/rejection rate.