A five-year review of necrotizing fasciitis at Jimma University Specialized Hospital, Jimma, Ethiopia

Necrotizing bacterial infections are extremely serious, fulminant infections of the soft tissues by virulent bacteria. The annual incidence of NF is estimated at 500–1,000 cases annually, and its prevalence globally has been reported to be 0.40 cases per 100,000 populations. It is seen to have a predilection for men, with a male-to-female ratio of 3:1. The disease affects all age groups. Clinical risk factors for necrotizing soft-tissue infection include diabetes mellitus, malnutrition, obesity, chronic alcoholism, peripheral vascular disease, chronic lymphocytic leukaemia, steroid use, renal failure, cirrhosis and autoimmune deficiency syndrome. The mortality associated with NSTI has been in the range of 16 to 45%. Necrotizing fasciitis is common in Ethiopia but the prevalence and risk factor patterns of the disease in Ethiopia setup have not been well studied. The main objective of this study was to assess pattern and outcome of necrotizing fasciitis in Ethiopia. A retrospective cross-sectional study design was conducted, by reviewing medical records of patients who developed necrotizing fasciitis during the period between January 1, 2011 and December 31, 2015 in Jimma University specialized hospital. Overall, 78 patients were diagnosed with necrotizing fasciitis and mortality rate was 19.23%. The mean age of patients was 36.33 years (range: 37 days to 80 years). Male to female ratio was 2.39:1. Seventy percent were from rural area and 39.7% had predisposing factor. The most common site affected is lower limb (39.7%) and the next common is perineum (34.6%). The median duration of hospital stay was 25.23 days. This five-year review has shown a low incidence of necrotizing fasciitis infection with a high mortality rate. Diabetes mellitus, RVI and malnutrition were identified as the main co-morbidities.