review · Tropical Medicine and Health
Foreign body aspiration is a time-sensitive emergency and a major cause of accidental death in young children, yet data from sub-Saharan Africa have remained limited. A systematic review and meta-analysis of fourteen studies encompassing 748 children across eight countries assessed the regional epidemiology, clinical features, and outcomes. Across all settings, boys represented 61 percent of cases. Presentation age varied considerably, with children under three years comprising the majority in East Africa. Organic items made up 54 percent of all aspirated objects, revealing three clear geographic patterns: seeds predominated in East Africa, inorganic items like plastics and metals led in southern Africa, and West Africa displayed a mixed profile. Tracheal lodgement occurred in 15 percent of cases, overall mortality was 2 percent, and pneumonia occurred in roughly one-third of reported cases. The findings highlight that prevention efforts must be tailored to regional variations rather than applied uniformly.
Foreign body inhalation is a critical, life-threatening emergency in young children. Understanding regional differences in the types of objects inhaled and the age groups most affected allows public health authorities and clinicians to design targeted, culturally and geographically relevant safety campaigns. This can reduce preventable childhood deaths and complications across sub-Saharan Africa.
The abstract provides epidemiological evidence rather than developing a commercial product or technical process. These findings could inform public health agencies and safety equipment developers designing targeted child safety products or educational programmes, but the abstract does not indicate an application pathway or commercialisation pipeline.
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Foreign body aspiration (FBA) is a significant cause of accidental death in children under three years worldwide and is perhaps the most time-sensitive emergency in pediatric medicine. While high-income countries have established surveillance systems, the burden and characteristics of pediatric FBA in sub-Saharan Africa remain poorly characterized. This systematic review and meta-analysis aims to synthesize available evidence on the epidemiology, clinical characteristics, and outcomes of pediatric FBA across the region. We conducted a systematic search of PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar from inception to January 2026, with no language restrictions. Studies reporting original data on children (0–18 years) with confirmed tracheobronchial foreign body aspiration in sub-Saharan African countries were included. Case reports (n < 5), editorials, and studies that did not report both age and sex distribution were excluded. We performed random-effects meta-analysis using the restricted maximum likelihood method to pool proportions for outcomes reported by at least five studies, with heterogeneity assessed using the I 2 statistic. Pre-specified subgroup analyses were conducted by geographic region (East, West, and southern Africa). All analyses were performed using Stata version 17. Fourteen studies comprising 748 children from eight countries (Ethiopia, Nigeria, Ghana, Mali, Mozambique, South Africa, Tanzania and Togo) met inclusion criteria. Male predominance was consistent across all studies (pooled proportion 61%, 95% CI 58–64%, I 2 = 3.4%). Age at presentation varied markedly. Median age ranged from 2 years (Ethiopia) to 4.5 years (Tanzania), while mean age ranged from 2.8 years (Nigeria) to 5.7 years (South Africa). In East African studies, the majority of children were under 3 years of age. Organic foreign bodies comprised 54% of cases overall (95% CI 42–66%), but with extreme heterogeneity (I 2 = 93%, p < 0.001) revealing distinct geographic patterns. Seed aspiration dominated in East Africa (Ethiopia 87%, Tanzania 54%), while inorganic objects (plastics, metals) predominated in southern Africa (Mozambique 62%, South Africa 62%). West Africa showed mixed patterns. Tracheal location was consistently reported across studies (15%, I 2 = 0%), validating anatomical reporting, while bronchus location data were highly variable due to documentation differences. Pooled mortality was 2% (95% CI 1–3%, I 2 = 0.01%), with pneumonia affecting 31–33% of children in adequately reported series. Pediatric FBA in sub-Saharan Africa shows marked geographic variation, with a distinct three-zone pattern: an East African pattern (seeds), a southern African pattern (inorganic material) and a West Africa pattern (mixed: seeds and inorganic material). These findings suggest region-specific prevention strategies rather than uniform approaches.
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DOI: 10.1186/s41182-026-01049-8
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