BACKGROUND:
Noma (cancrum oris) is a devastating infectious disease causing severe facial disfigurement (Yunusa et al., 2013). Affecting children in extreme poverty (WHO, 2017), it was recently classified as a Neglected Tropical Disease (WHO, 2024). While physical aspects are studied, the psychological well-being of pediatric survivors is largely unknown (Onu et al., 2023). This study aimed to determine the prevalence of depressive symptoms and associated factors among pediatric Noma patients in Nigeria.

METHODS:
This cross-sectional study at Noma Children Hospital, Sokoto, recruited a convenience sample of 244 Noma patients (mean age 10.93 ± 3.17 years), aged 6–16. Children with critical health conditions or neurological disorders were excluded. Data were collected via the Center for Epidemiologic Studies Depression Scale (CES-D), with ≥16 indicating significant symptoms. Analysis included descriptive statistics, Chi-square tests, and binary logistic regression (p < 0.05).

RESULTS:
An alarmingly high prevalence (76.6%; 95% CI 70.9–81.4%) of depressive symptoms was found. Bivariate analysis showed significant associations between depression and gender (p=0.005), parental education (p<0.001), household income (p=0.030), and family structure (p=0.013). The final logistic regression model (χ²(7) = 33.33, p < .001) explained 24.4% (Nagelkerke R²) of the variance. Significant predictors for high depressive symptoms included being female (OR=3.251, 95% CI 1.499–7.048) and, paradoxically, higher household income (OR=3.411, 95% CI 1.624–7.167). Parental employment was a significant protective factor (OR=0.401, 95% CI 0.217–0.739).

CONCLUSIONS:
The prevalence of depressive symptoms among pediatric Noma patients is extremely high, with risk shaped by gender and complex socioeconomic factors. These findings demonstrate an urgent need to integrate mental health screening and psychosocial support services into all Noma treatment protocols, with prioritized evaluation for high-risk groups.