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 (<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 corresponding factors with 60.0%
and 86.7% respectively. There were significant differences in victims’
perception of noma [χ2 =
45.536, (P < 0.001)] and acceptance of their new faces [P = 0.023], between
the social acceptance and social rejection rate, therefore all patients who
accepted their new faces felt social acceptance. Social acceptance was
significantly highly correlated with pathological history (admission method,
phase of noma, care, and treatment received at center) with rs 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
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