Infant oral mutilation at Bor State Referral Hospital, Bor, South Sudan

Introduction: Infant Oral Mutilation (IOM) is a traditional practice involving the extraction of unerupted teeth in young infants. Tooth swellings are mistaken for the cause of diarrhoea and fever. The practice is performed across East Africa and is highly dangerous due to the risk of blood-borne diseases, blood loss, anaemia, septicaemia, and death. The objective of this survey was to describe the practice of IOM, locally known as Hooth, in the population in and around Bor town, South Sudan.Method: The mothers of 150 children aged under six months admitted to the Paediatric or Maternity wards of Bor State Referral Hospital with a history of fever, poor feeding, and/or convulsions were administered a structured questionnaire to determine their attitudes towards and practices of Hooth. A focused group discussion was conducted in the community to find out the general opinion about Hooth.Results: Most of the mothers were young with low literacy. The commonest symptom of the children on admission was fever, and the commonest diagnosis was malaria. 86% of the children had undergone Hooth seven days before admission. All, except one, of the mothers thought that Hooth was not harmful and was performed to treat the fever associated with teething. Teeth were extracted using unsterile instruments, mostly by traditional healers. The group discussion revealed that the practice is not indigenous to the Dinka tribe and likely originated from multiple sources.Conclusion: IOM is common among children under 6 months of age admitted to the hospital with fever, feeding problems, or convulsions. The dangers of IOM are widely known, and health care workers should be advised to examine for Hooth in children aged under six months admitted with fever. It is recommended that IOM be banned and that mothers be taught how to manage fever and teething problems.