What the Absence of Publications on Cervico-Facial Cellulitis in Sub-Saharan Africa Reveals: A Bibliometric Analysis

Abstract

Cervico-facial cellulitis represents a major challenge in sub-Saharan Africa. Many assume that these infections have unfavorable outcomes in this region, but very few scientific studies exist to confirm this. This scarcity of publications raises an important question: does it reflect truly poor hidden outcomes or rather a lack of resources to conduct research? Our objective was to analyze how many scientific studies have been published on these infections in sub-Saharan Africa and verify whether biases exist in what is published or not. We conducted a bibliometric analysis from 2010 to 2023. We searched all major scientific databases and applied specialized statistical tests to detect publication bias (Egger's and Begg's tests). Ultimately, we identified only 7 studies involving 487 patients across 6 countries. This represents 0.5 studies per year over a 13-year period. Publications are primarily concentrated in Nigeria and Mali, with a notable absence in Southern and Eastern Africa. The reported mortality rates vary from 4.4% to 20% with a weighted average of 11.2%. Our statistical tests detect no significant publication bias. In conclusion, scientific production is even lower than expected, but clinical outcomes remain within acceptable ranges. The lack of studies reflects more of a research capacity problem than a cover-up of poor results.