{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T02:44:49Z","timestamp":1785293089990,"version":"3.55.0"},"reference-count":42,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,6,8]]},"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To summarise available data on the risk factors, complications and the factors associated with complications of lower limb cellulitis in Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We did electronic searches on PubMed, EMBASE, Scopus and African Journals Online from 1 January 1986 to 30 October 2017, extracted and summarised data on the risk factors, complications and the factors associated with the complications of lower limb cellulitis from eligible literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of seven studies were retained for final review after the search and screening processes. Local risk factors of cellulitis reported were: disruption of the skin barrier, neglected wounds, toe-web intertrigo, leg ulcers, use of depigmentation drugs and leg oedema. Obesity was the only reported general risk factor of cellulitis. Five studies reported on the complications of cellulitis which included: abscess formation, necrotising fasciitis, bullae, haemorrhagic lesions, necrosis, phlebitis and amputations. Nicotine addiction, chronic use of non-steroidal anti-inflammatory drugs, delay in the initiation of antibiotic treatment and elevated erythrocyte sedimentation rate were risk factors of complications of lower limb cellulitis identified from three studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review highlights the important role of local risk factors in the pathogenesis of lower limb cellulitis in Africa. The association between voluntary skin depigmentation and lower limb cellulitis should alert public health authorities and the general population to the health risks associated with this practice. The identification and improved management of the risk factors of lower limb cellulitis and its complications could go a long way in decreasing the morbidity and health costs incurred by lower limb cellulitis in Africa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-021175","type":"journal-article","created":{"date-parts":[[2018,7,23]],"date-time":"2018-07-23T03:36:15Z","timestamp":1532316975000},"page":"e021175","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Risk factors and complications of lower limb cellulitis in Africa: a systematic review"],"prefix":"10.1136","volume":"8","author":[{"given":"Frank-Leonel","family":"Tianyi","sequence":"first","affiliation":[{"name":"Department of General Medicine, Mayo Darley Sub-divisional Hospital, Banyo, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarence Mvalo","family":"Mbanga","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Mankon Sub-divisional Hospital, Bamenda, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7976-4331","authenticated-orcid":false,"given":"Celestin","family":"Danwang","sequence":"additional","affiliation":[{"name":"Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaound\u00e9 I, Yaound\u00e9, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6708-6852","authenticated-orcid":false,"given":"Valirie Ndip","family":"Agbor","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Ibal Sub-divisional Hospital, Oku, Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,7,23]]},"reference":[{"key":"2025120520565674000_8.7.e021175.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199601253340407"},{"key":"2025120520565674000_8.7.e021175.2","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/QCO.0b013e32805dfb2d","article-title":"Acute bacterial skin infections and cellulitis","volume":"20","author":"Gabillot-Carr\u00e9","year":"2007","journal-title":"Curr Opin Infect Dis"},{"key":"2025120520565674000_8.7.e021175.3","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200304030-00002"},{"key":"2025120520565674000_8.7.e021175.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e4955"},{"key":"2025120520565674000_8.7.e021175.5","first-page":"11","article-title":"[Erysipelas: epidemiological, clinical and therapeutic data (111 cases)]","volume":"118","author":"Crickx","year":"1991","journal-title":"Ann Dermatol Venereol"},{"key":"2025120520565674000_8.7.e021175.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7369.864"},{"key":"2025120520565674000_8.7.e021175.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1990.tb04833.x"},{"key":"2025120520565674000_8.7.e021175.8","doi-asserted-by":"crossref","first-page":"519","DOI":"10.3109\/00365548609021656","article-title":"Epidemiological, bacteriological and complicating features of erysipelas","volume":"18","author":"Jorup-R\u00f6nstr\u00f6m","year":"1986","journal-title":"Scand J Infect Dis"},{"key":"2025120520565674000_8.7.e021175.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2010.03978.x"},{"key":"2025120520565674000_8.7.e021175.10","unstructured":"Africa CiS;Pages. http:\/\/ global-disease burden.healthgrove.com\/l\/82932\/Cellulitis-in-South-Africa"},{"key":"2025120520565674000_8.7.e021175.11","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1016\/S0140-6736(16)31460-X","article-title":"Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"Kassebaum","year":"2016","journal-title":"The Lancet"},{"key":"2025120520565674000_8.7.e021175.12","unstructured":"Transforming our world: the 2030 Agenda for Sustainable Development. 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