Conference abstract
Traditional methods of managing paediatric hepatomegaly and splenomegaly in three hospitals in the Limbe Health District
Pan African Medical Journal - Conference Proceedings. 2023:17(129).04
Jun 2023.
doi: 10.11604/pamj-cp.2023.17.129.1614
Archived on: 04 Jun 2023
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Keywords: Scarification, children, burden, predisposing factors, outcome
Poster
Traditional methods of managing paediatric hepatomegaly and splenomegaly in three hospitals in the Limbe Health District
Naiza Monono1,&, Kate-Kan2, Mulango Ene1, Verla Vincent1, Halle-Ekane3
1Department of Internal Medicine and Paediatrics, University of Buea, Buea, Cameroon, 2Department of Clinical Science, University of Bamenda, Bamenda, Cameroon, 3Department of Obstetrics and Gynecology, University of Buea, Buea, Cameroon
&Corresponding author
Introduction: the practice of scarification in children for medical reasons is common in a vast number of African communities with its origin lost in antiquity. There are several reasons that prompt people to get their children scarified and the practice is known to have fatal outcomes. There is a paucity of information in the published medical literature on the burden and predisposing factors of this practice in Cameroon. The objective of this study was to assess the burden, predisposing factors, and outcome of scarification among children less than 15 years old in three hospital settings of the Limbe Health District.
Methods: a three-month hospital-based cross-sectional study was carried out. A structured questionnaire was used to collect data from each parental participant. Data was analyzed using SPSS version 26 and the threshold for statistical significance was set at 0.05 at 95% confidence interval.
Results: a total of 240 guardians were enrolled in our study representing the number of children under 15 years old. The most represented age group was < 5 years old, 151(62.9%), and most were scarified at ages less than 5 years, 111(46.3%). The sex ratio was 1.5:1. Amongst the hospitalized children the most worrisome symptoms to their guardians were fever 231 (96.3%), generalized body weakness 181(75.4%), and tachycardia 99(41.3%) all prompting the act of scarification. The proportion of children with scarifications was 137 (57.1%). Ninety-five (69.3%) were located below the left nipple, 104 (75.9%) were mechanical scars and 135 (98.5%) were performed by a herbalist under non-sterile conditions. Factors associated with scarification were left-sided abdominal pain (p<0.00, OR=7.3 at 95% CI [2.96-18.3]), tachycardia (p=0.001, OR=5.5 at 95% CI [2.4-12.9]), and at least one scarified sibling (p=0.001, OR=5.9 at 95% CI [2.0-17.4]). Dissuading factors were generalized body weakness (p=0.00, OR=0.1 at 95% CI [0.0-0.2]), low level of educational achievement (p=0.003, OR=0.2 at 95% CI [0.1-0.6]), and a low-income (p=0.031, OR=0.4 at 95% CI [0.2-0.9]). Among the complications, 1(0.7%) was infected with the human immune-deficiency virus related to the act, 3(2.2%) had infected wounds at the scar sites and there were 2(1.5%) death cases.
Conclusion: the hospital burden of scarification amongst children is relatively high and predisposing factors are mostly linked to the clinical state of the child and having at least 1 scarified sibling. Though very few children were confirmed to suffer from complications, the death of a child due to the delay of appropriate treatment is a wake-up call to the weight of community Paediatrics we have to invest in, to save the Paediatric population.
Traditional methods of managing paediatric hepatomegaly and splenomegaly in three hospitals in the Limbe Health District
Naiza Monono1,&, Kate-Kan2, Mulango Ene1, Verla Vincent1, Halle-Ekane3
1Department of Internal Medicine and Paediatrics, University of Buea, Buea, Cameroon, 2Department of Clinical Science, University of Bamenda, Bamenda, Cameroon, 3Department of Obstetrics and Gynecology, University of Buea, Buea, Cameroon
&Corresponding author
Introduction: the practice of scarification in children for medical reasons is common in a vast number of African communities with its origin lost in antiquity. There are several reasons that prompt people to get their children scarified and the practice is known to have fatal outcomes. There is a paucity of information in the published medical literature on the burden and predisposing factors of this practice in Cameroon. The objective of this study was to assess the burden, predisposing factors, and outcome of scarification among children less than 15 years old in three hospital settings of the Limbe Health District.
Methods: a three-month hospital-based cross-sectional study was carried out. A structured questionnaire was used to collect data from each parental participant. Data was analyzed using SPSS version 26 and the threshold for statistical significance was set at 0.05 at 95% confidence interval.
Results: a total of 240 guardians were enrolled in our study representing the number of children under 15 years old. The most represented age group was < 5 years old, 151(62.9%), and most were scarified at ages less than 5 years, 111(46.3%). The sex ratio was 1.5:1. Amongst the hospitalized children the most worrisome symptoms to their guardians were fever 231 (96.3%), generalized body weakness 181(75.4%), and tachycardia 99(41.3%) all prompting the act of scarification. The proportion of children with scarifications was 137 (57.1%). Ninety-five (69.3%) were located below the left nipple, 104 (75.9%) were mechanical scars and 135 (98.5%) were performed by a herbalist under non-sterile conditions. Factors associated with scarification were left-sided abdominal pain (p<0.00, OR=7.3 at 95% CI [2.96-18.3]), tachycardia (p=0.001, OR=5.5 at 95% CI [2.4-12.9]), and at least one scarified sibling (p=0.001, OR=5.9 at 95% CI [2.0-17.4]). Dissuading factors were generalized body weakness (p=0.00, OR=0.1 at 95% CI [0.0-0.2]), low level of educational achievement (p=0.003, OR=0.2 at 95% CI [0.1-0.6]), and a low-income (p=0.031, OR=0.4 at 95% CI [0.2-0.9]). Among the complications, 1(0.7%) was infected with the human immune-deficiency virus related to the act, 3(2.2%) had infected wounds at the scar sites and there were 2(1.5%) death cases.
Conclusion: the hospital burden of scarification amongst children is relatively high and predisposing factors are mostly linked to the clinical state of the child and having at least 1 scarified sibling. Though very few children were confirmed to suffer from complications, the death of a child due to the delay of appropriate treatment is a wake-up call to the weight of community Paediatrics we have to invest in, to save the Paediatric population.
