Prevalence of significant depressive symptoms and associated factors among facially disfigured pediatric Noma patients in Nigeria: A single-centre cross-sectional study

Abstract

Noma is a neglected tropical disease that causes severe facial disfigurement and significant morbidity, yet there is limited evidence regarding the psychological well-being of affected children. This study aimed to determine the prevalence of depressive symptoms and identify associated factors among pediatric Noma patients attending the Noma Children Hospital in Sokoto, Nigeria. A cross-sectional study was conducted involving 244 pediatric patients aged 6-16 years who had been facially disfigured by Noma and were undergoing rehabilitation or awaiting surgery. Data were collected using a structured questionnaire that included sociodemographic characteristics and the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms. Binary logistic regression was performed to identify predictors of high depressive symptoms. Statistical significance was set at p < 0.05. The prevalence of clinically significant depressive symptoms among the participants was 76.6% (95% CI: 70.9-81.4%). Multivariate analysis revealed that gender, parental employment, and household income were associated with depressive symptoms. Female patients were significantly more likely to exhibit high depressive symptoms compared to males (OR = 3.251, 95% CI: 1.499-7.048, p = 0.003). Higher household income was associated with increased odds of depressive symptoms (OR = 3.411, 95% CI: 1.624-7.167, p = 0.001), whereas parental employment was significantly associated with reduced odds (OR = 0.401, 95% CI: 0.217-0.739, p = 0.003). There is a substantial burden of depressive symptoms among pediatric Noma patients in Nigeria, with female gender and family socioeconomic factors significantly shaping the risk. These findings highlight the critical need to integrate mental health screening and psychosocial interventions into Noma care protocols.