Influencing Factors for Social Acceptance of Noma (Cancrum Oris) Patients in Niger: A Hospital-Based Cross-Sectional Study

Abstract

Background: Noma, mostly identified in malnourished young children in the world鈥檚 low-income countries, causes severe orofacial disfigurement and sig-nificant 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 accep-tance/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鈥檚 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 (<30 days), and patients in the acute phase of noma had a significantly high social acceptance rate with 60.0%, 82.9%, 60.0%, 57.1% and 94.3% respectively; whereas single adults and cheek lesion site had the highest social rejection rate when compared to their cor-responding factors with 60.0% and 86.7% respectively. There were significant differences in victims鈥?perception of noma [蠂2 = 45.536, (P < 0.001)] and ac-ceptance of their new faces [P = 0.023], between the social acceptance and so-cial rejection rate, therefore all patients who accepted their new faces felt social acceptance. Social acceptance was significantly highly correlated with pa-thological history (admission method,