02739nas a2200337   4500000000100000008004100001260004400042653001200086653001700098653001700115653002700132653002300159653001200182653001200194100001300206700001200219700001600231700001600247700001700263700001400280700001500294700001400309700001400323700001600337245011200353856007300465300000900538490000700547520183300554022001402387       2024                            d  bSpringer Science and Business Media LLC10aNigeria10aCancrum oris10aMalnutrition10a Stomatitis gangrenosa10aCase fatality rate10aMalaria10aMeasles1 aEleje GU1 aOkoh EE1 aIgbodike EP1 aAkinsolu FT1 aNwaokorie FO1 aLusher JM1 aTantawi ME1 aSalako AO1 aEzechi OC1 aFoláyan MO00aPrevalence and associated risk factors for noma in Nigerian children: a systematic review and meta-analysis  uhttps://link.springer.com/content/pdf/10.1186/s12903-024-04451-y.pdf  a1-140 v243 a<p><strong>Objectives:</strong> To determine the prevalence, case-fatality rate, and associated risk-factors of Noma in children in Nigeria.</p>

<p><strong>Methods:</strong> 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.</p>

<p><strong>Results:</strong> 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;&nbsp;Z = 7.60;&nbsp;p &lt; 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&nbsp;(88.42%,&nbsp;95%CI:52.84–124.00;&nbsp;I2:100.0), measles&nbsp;(40.60%;&nbsp;95% CI:31.56–49.65;&nbsp;I2:100.0) and malaria&nbsp;(30.75%;&nbsp;95% CI:30.06–31.45;&nbsp;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&nbsp;studies) than in northern (4.43%;&nbsp;95%CI:-0.98-9.83;&nbsp;4&nbsp;studies) Nigeria. One study reported the prevalence of Noma in children younger than 5 years.</p>

<p><strong>Conclusions: </strong>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.</p>
  a1472-6831