Surgery

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Browsing Surgery by Author "Alamne,Getaw(MD)"

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    Patterns of Noma (Cancrum Oris), in Ethiopia: A Retrospective, Multicentric cross-sectional study
    (Addis Ababa University, 2023-06) Gelaw,Lealem Tilahun; Eshete,Mekonen (Ass.Prof.); Alamne,Getaw(MD)
    Background: Noma is a polymicrobial infectious disease affecting mostly malnourished children under the age of 10. It is a gangrenous disfiguring disease of the orofacial tissue and the tissue gangrene or necrosis starts in the mouth and eventually spreads intraorally with the destruction of soft and hard tissues. If not controlled, 90% of cases, the disease is lethal because of systemic sepsis. The natural course of the condition leads to perforation through the skin of the face, creating a severe cosmetic and functional defect. The resulting disfiguring facial appearance results in patients being disabled and socially isolated. Objectives: The main objective of this study was to determine the pattern of Noma, risk factor, the sequela and severity of Noma survivor patient treated, with the support of Facing Africa, in different hospitals in Ethiopia. Methods: : Hospital based retrospective cross-sectional study done on patients treated, with the support of Facing Africa between 2007 up to 2020. The study population was Noma patients treated during the study period. The data retrieved from Facing Africa database, cleaned, coded and entered with Epi-data version 7 and further analyzed using SPSS version 25. Result: The data of 103 patients was retrieved for this study, 53 males and 50 females. The age ranged between 1and 62 years, the majority were between16-29 years. Most came from rural area (74.8%) mainly from Amhara and Oromia region and most are Muslim and Orthodox by religion. 54% are single and (60.2%) do not have formal education and farmers by occupation(41.7%). (47.6%) use tap water, 83.5% do not have any addiction, (83.5%) do not have any co morbidity and 66% do not know their vaccination status. 93(90.3%) is not happy with their appearance and 77(74.8%) suffer from bulling. 62(60.2 %) cover their face in public. 14(13.6%) of patients were unable to go in public. Difficulty of eating occur in 80(77. %), difficulty of communication or speech in 56(54.4%), difficulty of mouth opening 40 (38.8%), visual problem in 19(18.4%) and difficulty of breathing in 10(9.7%). Of the total procedures performed, Sub mental flap done for 51(49.5%) and radial forearm free flap done for 21(20.4%) patients. Wound infection occur in 23(22.3%) of patients and flap failure occur in 17(16.5%) of patients. Secondary procedures like scar revision was done for 68 (66%) patients, commisuroplasty for 33 (32%) patients and debulking for 23(22.3%). Conclusion: This study indicates that patients typically present in their late adolescence after experiencing various forms of discriminatory and psychosocial harassment, which negatively impacts their literacy and financial status. These results imply that Noma reconstruction is a challenging procedure that needs multiple stages and revisions, and that there are still some problems and challenges. Thus, surviving Noma is a testament to human resilience, but the journey does not end with recovery.