Scarrifications Hospital Review of a Traditional Method of Managing Paediatric Hepatomegaly and Splenomegaly in Three Hospitals in the Limbe Health District, Cameroon

Abstract

Background: This practice of scarifying children for medical reasons is common in several African communities with its origin lost in antiquity. A few reasons prompt people to get their children scarified and the practice may have fatal outcomes. In Cameroon where no study has been carried out on this aspect, we saw it necessary to review this practice and its outcome. Objectives: To assess the prevalence, 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 participant. Data was analyzed using SPSS version 26 and statistical significance was set at p-value <0.05 at 95% confidence interval. Results: Out of 240 participants enrolled in the study males were predominant (59.6%). We had a scarification prevalence of 57.1% with majority scarified before 5years of age. The majority had fever 96.25%, 41.3% had palpitations and 27.9% had left abdominal pain prompting the act. About 69.3% of the participants were scarified below the left nipple, 75.9% had mechanical scars and 98.5% were performed by a herbalist under unsterile conditions. Factors prompting scarification were, left abdominal pain, palpitations, having a scarified sibling. While a lower level of education, low-income levels of the carers and generalized body weakness discouraged the act. Among the complications, 0.7% had HIV infection related to the act, 2.2% had infected wounds at the site of the scar and 1.5% death cases were recorded. Conclusion: In this study, approximately 6 out of 10 children undergo physical insult to treat a reactional hepatomegaly and splenomegaly by a herbalist under unsterile conditions yet, 1 out of 10 of these children died and 3 out of 10 suffered from complications of the act.