Abstract
Background: The practice of inflicting cuts (incisions) on the anterior abdominal wall to treat splenomegaly of various causes is a very common one in some parts of Edo State, Nigeria. Such incisions may result in several complications including sepsis (especially in children who are the major targets); massive blood loss leading to symptomatic anemia that may require blood transfusions or lead to death and massive keloidal growth as sequelae in some of the patients. This practice is a long-term practice of the Esan people of the central part of Edo State Nigeria. This study aims to identify the factors that continue to make this practice attractive to members of the community, the common complications encountered, and how to develop an advocacy tool for health education and promote the health-seeking behavior of the populace.
 Methods: This was a prospective community based cross-sectional descriptive study that was conducted in all the 5 Esan speaking local government areas of Edo State where this practice is very common. The study was done between January 2017 and June 2018. Participants were interviewed using a structured questionnaire by previously trained researchers, after pretesting and validation. The questionnaire was administered on 700 adults, however, 500 were returned. The data obtained were summarized as frequencies and percentages.
 Results: The majority of the participants were middle-aged. Ninty-five percent (95%) of respondents were aware of the practice of abdominal scarification and 80% of them think it is effective. It was mainly carried out by herbalists in 95% of the respondents. Half of the respondents were unaware of any complications associated with the procedure.
 Conclusion: Abdominal scarification is a common practice among the Esan people of south-south Nigeria. They believe it's effective, affordable, and risk-free. This is despite the availability of effective alternatives in orthodox medicine. There is, therefore, a need for advocacy and health education considering the dangers and complications associated with the practice.
Highlights
The art of deliberately inflicting cuts on the body and allowing it to heal by delayed intention resulting in visible scars or scarifications is a long-time practice among Africans those of west African or sub-Saharan African descent [1]
The practice of inflicting cuts on the anterior abdominal wall to treat splenomegaly of various causes is a very common one in some parts of Edo State, Nigeria. Such incisions may result in several complications including sepsis; massive blood loss leading to symptomatic anemia that may require blood transfusions or lead to death and massive keloidal growth as sequelae in some of the patients
Ninty-five percent (95%) of respondents were aware of the practice of abdominal scarification and 80% of them think it is effective
Summary
The art of deliberately inflicting cuts on the body and allowing it to heal by delayed intention resulting in visible scars or scarifications is a long-time practice among Africans those of west African or sub-Saharan African descent [1]. The practice of inflicting cuts (incisions) on the anterior abdominal wall to treat splenomegaly of various causes is a very common one in some parts of Edo State, Nigeria. Such incisions may result in several complications including sepsis (especially in children who are the major targets); massive blood loss leading to symptomatic anemia that may require blood transfusions or lead to death and massive keloidal growth as sequelae in some of the patients. Conclusion: Abdominal scarification is a common practice among the Esan people of south-south Nigeria They believe it's effective, affordable, and risk-free. There is, a need for advocacy and health education considering the dangers and complications associated with the practice
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