Cervicofacial Necrotizing Fasciitis in Africa: A Systematic Review of Hospital Prevalence, Management, and Clinical Outcomes

Background: Cervicofacial necrotizing fasciitis (CNF) is a rare but life-threatening soft tissue infection in the head and neck region of the body, characterized by rapid progression and high mortality rates. Limited comprehensive data exist on its epidemiology and management across the African continent. Objective: To systematically review the hospital prevalence, etiological factors, management strategies, and clinical outcomes of cervicofacial necrotizing fasciitis in Africa. Methods: A systematic review of published studies on cervicofacial necrotizing fasciitis from African countries was conducted. Database searches were performed using keywords including "cervicofacial necrotizing fasciitis," "prevalence," "etiology," "management," and "outcome." Studies conducted in Africa that specifically focused on cervicofacial necrotizing fasciitis were included. Data were extracted and analyzed using SPSS version 20. Results: Seventeen studies encompassing 333 patients from six African countries were included. The mean age in the studies was 41.86 ± 17.99 years with a male predominance (53.15%). Odontogenic infections accounted for 89.1% of cases, with mandibular teeth involvement in 70.3% of cases. The submandibular region was the most affected anatomical site (36.6%). Diabetes mellitus was the most prevalent comorbidity (55.8% of patients with comorbidities). Streptococcus species were the most frequently isolated organisms (40.7%). Mean hospital stay was 23.2 ± 13.3 days, with a mean presentation delay of 15.39 ± 11.9 days. The overall mortality rate was 4.8%, with sepsis-related deaths occurring in 11.6% of patients with complications. Conclusion: Cervicofacial necrotizing fasciitis in Africa predominantly affects middle-aged males and is primarily odontogenic in origin. Late presentation remains a significant challenge. Early recognition, prompt surgical debridement, and broad-spectrum antibiotic therapy are essential for favorable outcomes. Enhanced public health education regarding dental hygiene and timely management of odontogenic infections is crucial.