Almajiri health; a scoping review on disease, health literacy and space for participatory research

INTRODUCTION: Almajirai are male children in Northern Nigeria and Southern Niger who study Islam in the almajiranci system. Almajiranci has been associated with non-participation in formal education, abuse, poverty, and underdevelopment. However, the peer-reviewed literature around health among almajirai remains limited. We conduct a scoping review around almajiri health to synthesize evidence for health problems, draw links between findings, identify research gaps, indicate areas for intervention, and assess participatory approaches in this literature. METHODS: We searched the academic literature for articles concerning almajiri heath using a framework integrating the biopsychosocial and socio-ecological models of health. We included articles in English and French published between 2000 and 2022. For each study we collected information regarding authorship, study year and location(s), study design and aims, sample characteristics, findings, and almajiri participation in research design, execution, interpretation and dissemination. RESULTS: Of 1,944 studies, 17 were found relevant for data extraction. These included 14 cross-sectional studies, 2 descriptive articles, and one case-control study. All were conducted in Nigeria, though one included Nigerien almajirai. No study engaged almajirai in participatory roles. Domains evaluated included infectious disease (10 studies), oral health (2 studies), workplace injury, nutrition, health status, health determinants, and mental health (1 study each). Almajirai included ranged from 3 to 28 years old. Included studies found high rates of malaria, intestinal parasitosis, urinary tract infection, N. meningitidis, and occupational injury among almajirai. Studies comparing almajirai to controls found significantly higher rates of cholera, urinary schistosomiasis, and psychiatric disorders, lower levels of rabies awareness and poorer oral hygiene among almajirai (p<0.05). One study, concerning nutrition, described an intervention to improve almajiri health, though did not provide health outcomes for that intervention. CONCLUSION: We find that the literature around almajiri health has concerned a broad range of domains, though the number of studies within each domain remains limited. We further note limitations in the geographic scope of this literature, interventions to improve almajiri health, and the consideration of demographic features, like age, that may influence almajiri health. We stress the need for further study in these areas, and for participatory approaches, which may be more likely to effectively improve almajiri health.