| Noma | |
|---|---|
| Other names | cancrum oris, stomatitis gangrenosa |
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| Stage 3 noma (gangrenous stage) in a young girl | |
| Specialty | Pediatrics, otorhinolaryngology, dentistry  |
| Symptoms | Facial edema, fever, gangrene of face |
| Complications | sepsis & death, facial disfigurement, difficulty eating/drinking, social stigma |
| Usual onset | age 2-6 years |
| Duration | acute phase lasts 2-4 weeks |
| Causes | Opportunistic infection |
| Risk factors | Extreme poverty, malnutrition, immunosuppression |
| Diagnostic method | Based on symptoms |
| Differential diagnosis | Oral cancer, leishmaniasis, leprosy |
| Prevention | Adequate nutrition, oral hygiene |
| Treatment | Antibiotics, nutritional supplements, oral hygiene |
| Medication | antibiotics |
| Prognosis | 90% fatality rate without treatment |
| Frequency | 140,000 new cases per year (1998 estimate) |
Noma (also known as gangrenous stomatitis or cancrum oris) is a rapidly-progressive and often-fatal gangrenous infection of the mouth and face. Noma usually begins as an ulcer on gums and rapidly spreads into the jawbone, cheek, and soft tissues of the face. This is followed by death of the facial tissues and fatal sepsis. Survivors are left with severe facial disfigurement often with impairments in breathing, swallowing, speaking and vision.[1][2][3][4] In 2023 noma was added to the World Health Organization's list of neglected tropical diseases.[5]
This disease is strongly linked to poverty and malnutrition, and predominantly affects children between the ages of two and six years in the least developed countries around the world, primarily in sub-Saharan Africa; noma has also been seen in severely immunocompromised people in the developed world. It is preventable by proper nutrition and oral hygiene. Noma is most common in impoverished environments with poor healthcare infrastructure; as a result many cases go undiagnosed, untreated and unreported. There are no reliable estimates of its prevalence – in 1998 WHO estimated that there were 140 000 cases per year with a fatality rate of 90%; no more recent estimates are available.[1][2][3][4]
Noma is an opportunistic infection linked to a number of microbes which take advantage by malnutrition and compromised immunity. There is no evidence of direct transmission from person to person. In the early stages, it can be treated effectively with antibiotics and nutrition supplements. If diagnosed early enough, there can be proper wound-healing. After recovering, patients with disfigurement require complex surgical rehabilitation.[1][2][3][4]
Noma survivors experience high levels of stigma, social isolation, and discrimination within their communities. These can be countered by education and community outreach programs.[3]
- ^ a b c "Noma – Key facts". World Health Organization. 15 December 2023. Retrieved 19 December 2023.
- ^ a b c Enwonwu, C.O.; Falkler, W.A.; Idigbe, E.O. (April 2000). "Oro-Facial Gangrene (Noma/Cancrum Oris): Pathogenetic Mechanisms". Critical Reviews in Oral Biology & Medicine. 11 (2): 159–171. doi:10.1177/10454411000110020201. ISSN 1045-4411.
- ^ a b c d "Issues & Crises – Noma". Médecins Sans Frontières (Doctors Without Borders). 4 January 2024. Retrieved 4 January 2024.
- ^ a b c Dutta, Sanchari Sinha (20 February 2023). "What is Noma (Cancrum oris)?". News-Medical.net. Retrieved 4 January 2024.
- ^ Johnson, Sarah (2023-12-15). "Survivors of disfiguring condition hail addition to WHO neglected diseases list". The Guardian. ISSN 0261-3077. Retrieved 2023-12-15.