Noma is a facial disfiguring childhood disease: Insights from cases of Noma in Ethiopia. Noma is a neglected infectious disease that causes severe destruction of facial tissues and poses a significant public health threat. The disease reportedly affects individuals with a debilitating health condition. This study aimed to identify the most vulnerable age group affected by Nomadisease and assess the severity of tissue damage among Noma cases in Ethiopia. A cross-sectional study was conducted to determine the age group most susceptible to noma and assess the disease-associated severity of tissue damage. The research objectives were met by scrutinizing electronic medical records of noma cases treated in Addis Ababa, Ethiopia, from 2007 to 2019, obtained from the Facing Africa database. Data collection
High burden of noma in the Gambella region of Ethiopia: a 12-year retrospective study on noma cases from the Facing Africa database. Noma, an infectious disease, mainly affects impoverished children. This study retrospectively assessed noma's prevalence in Ethiopia using data from the Facing Africa database and the 2022 United Nations Development Programme poverty index report. A thorough review of medical records spanning 2007 to 2019 identified a total of 235 noma cases. A standardized data extraction template was employed to systematically gather pertinent clinical and demographic data for subsequent analysis. Prevalence rates were calculated nationally and regionally for both the general population and children aged ≤10 y. The analysis revealed estimated national prevalence rates of 0.65 per
Is noma a neglected/overlooked tropical disease? Noma is a debilitating orofacial necrotizing bacterial disease that disproportionately affects impoverished malnourished persons, particularly young children, the vast majority of whom live in tropical and subtropical areas in sub-Saharan Africa. It has a very high mortality rate; causes significant physical and psychological morbidity as a neglected tropical disease (NTD). Most survivors of noma live with gross physical disfigurement and disability, and with impaired psychosocial functioning, so they are very often stigmatized and unjustifiably discriminated against. Owing to the paucity of evidence-based epidemiological data on noma, the relatively low number of people affected worldwide, and its apparently limited geographic distribution
Redefining the severity of orofacial tissue damage caused by noma: a novel classification approach. Noma is a severe orofacial disease with high mortality and morbidity. Although severity scales exist, they fail to fully capture the extent of damage caused by the disease. This study analysed 404 photos of 260 noma cases from Facing Africa (n=228) and Project Harar (n=32) to create a new severity by considering all tissue damage, including dentition, and allows for precise qualitative and quantitative assessment of disease severity. Continued research and validation are essential to refine this method, improving its clinical and research applications and enhancing outcomes for noma patients worldwide.
Understanding noma: WHO's recognition and the path forward in global health. The World Health Organization's (WHO) designation of noma as a neglected tropical disease (NTD) on 15 December 2023 marks a crucial advancement in global health efforts. This move sheds light on a condition predominantly affecting undernourished children in isolated regions of sub-Saharan Africa. Recognized as the 21st NTD, noma, or cancrum oris, is a serious condition leading to orofacial gangrene. The disease largely impacts young children and those with compromised immune systems, including individuals with human immunodeficiency virus or leukaemia. Determining the exact prevalence of noma is complex, hindered by rapid disease progression, societal stigma and a lack of reporting, especially in impoverished
Resurgence of Noma (Cancrum Oris) in Nigeria. Recent data from Médecins Sans Frontières and local health authorities highlight a concerning rise in noma cases across previously unaffected Nigerian states. Noma is a severe gangrenous disease affecting impoverished populations, causing severe facial disfigurement and high mortality rates, especially among children. Despite its eradication in developed regions, sub-Saharan Africa faces an escalating noma incidence. This communication highlights the urgent need for enhanced surveillance, awareness, regional treatment centers, and international support to mitigate its impact in Nigeria and avoid exacerbation of the condition across sub-Saharan Africa.
Clinical Diagnosis of Acute Noma: Essential Infection Markers and Clinical Presentations. In clinical settings, understanding the markers and clinical signs of infection is critical for timely diagnosis and treatment. However, a point-of-care diagnostic test is lacking for noma, a debilitating orofacial infectious disease. This retrospective study reviewed electronic medical records (EMRs a comprehensive approach that includes thorough clinical examination, appropriate disease stage classification, medical history review, and laboratory testing. The study highlights the critical infection markers and clinical presentations associated with acute noma that may aid in early diagnosis of the disease. Further research with a much larger number of participants is needed. However, given the difficulty
Estimation of the Prevalence of Noma in Ethiopia, 2007-2019: A Retrospective Study. Noma is a rapidly advancing and frequently deadly infection affecting the oral and facial regions. The condition causes severe destruction of the soft and osseous tissues of the face. Noma primarily affects impoverished children with weakened immune systems, yet epidemiological data on the disease are lacking . This cross-sectional study aimed to fill this knowledge gap by estimating the prevalence of noma in Ethiopia. A retrospective review of patients' medical records was conducted using data from the Facing Africa database, spanning from 2007 to 2019. The prevalence of noma was calculated for the general population and for children under 10 years old at national and regional levels. The estimation process
a case series of noma survivors in Laos. A retrospective analysis of data collected to monitor the care provided to Lao noma survivors who presented for treatment from 2002 to 2020 was conducted. The review assessed data including sociodemographic characteristics, diagnosis, mouth opening, self-reported quality of life at admission and after surgery, and the names used for the disease. Of the 50 in nutritional status and quality of life were evident after surgery. Patients referred to the disease as "Pak Phuey," which means diseased mouth. Noma survivors frequently live for years with disabling sequelae. Surgical rehabilitation improves the quality of life for noma survivors.
is a preventable disease. Indeed, the current noma status quo has been cast as a human rights shortfall, since this devasting disease overwhelmingly affects children from poor countries. At the recently held Noma Research Day, a renewed call for the World Health Organization (WHO) to recognize and include noma as one of the neglected tropical diseases was accompanied by a recognition that research into all aspects of noma has waned or remained completely lacking-particularly that which addresses the basic science questions of the etiology, pathophysiology/pathobiology, and underlying mechanisms of the disease. Yet, a lack of incremental knowledge on the various aspects of noma continues to hamper our composite understanding of its biology. Without a fundamental understanding of the biology of noma
More than 100 years of neglect: a bibliometric analysis of global research on noma (cancrum oris). Research plays a significant role in quantifying and addressing the burden of disease, improving healthcare delivery and developing evidence-based policy for neglected tropical diseases (NTDs). Since noma is not a recognised NTD by the World Health Organization (WHO), research activity is hypothesised to be low. This study aims to understand patterns and trends of research conducted on noma, to understand the patterns of citations, highlight networks of collaboration and analyse stakeholders in noma research. The SCOPUS database was selected and searched. Data analysis was conducted using the bibliometrix package for R in RStudio. Areas of interest included the distribution of research output
Initiative outreach on orofacial diseases across 34 states and the Federal Capital Territory in Nigeria over 10 years (2011-2020), which was aimed at contributing to an understanding of the epidemiology of noma in Nigeria. The data were collated and analyzed, and are presented in frequency distribution tables and charts. A total of 7,195 patients with noma were encountered. The northeastern region had Retrospective Characterization of Noma Cases Found Incidentally across Nigeria during Outreach Programs for Cleft Lip from 2011-2020. Reports of cases of noma in Nigeria remain scarce despite its known and devastating effects on victims. This report presents a retrospective cross-sectional study based on data regarding on patients with noma encountered incidentally during Oral Health Advocacy
orisComplications of cancrum orisPrognosisSynonyms: noma (from Greek: to devour); gangrenous stomatitis; face of poverty (flourishes where poverty is rife)What is cancrum oris?[1]Cancrum oris (noma) is a mutilating necrotising disease. The consequent necrotising fasciitis, myonecrosis, and osteonecrosis results in destruction of facial structures with severe functional impairment and disfigurement.Noma A, Duguma A; Noma - a neglected disease of malnutrition and poor oral hygiene: A mini-review. SAGE Open Med. 2022 May 1310:20503121221098110. doi: 10.1177/20503121221098110. eCollection 2022.Parikh TB, Nanavati RN, Udani RH; Noma neonatorum. Indian J Pediatr. 2006 May73(5):439-40.Paster BJ, Falkler Jr WA Jr, Enwonwu CO, et al; Prevalent bacterial species and novel phylotypes in advanced noma lesions. J
Noma in a boy with septic shock: a case report. Noma is a rare disease, which is characterized by rapid progression and a high rate of mortality; however, relatively few cases of noma infection accompanied by septic shock in children have been described. Further, most health care professionals have no knowledge of this disease or of its clinical significance. Herein, we present a case report -admission. Noma is an opportunistic infectious disease condition. Treatment of the acute phase of noma predominantly focuses on controlling the infection and improving systemic conditions. In addition, CRRT could be considered as a treatment option for cases that present with noma accompanied by septic shock.
Long-Term Exposure to Ambient Air Pollution and Subclinical Cerebrovascular Disease in NOMAS (the Northern Manhattan Study). Long-term exposure to ambient air pollution is associated with higher risk of cardiovascular disease and stroke. We hypothesized that long-term exposure to air pollution would be associated with magnetic resonance imaging markers of subclinical cerebrovascular disease . Participants were 1075 stroke-free individuals aged ≥50 years drawn from the magnetic resonance imaging subcohort of the Northern Manhattan Study who had lived at the same residence for at least 2 years before magnetic resonance imaging. Cross-sectional associations between ambient air pollution and subclinical cerebrovascular disease were analyzed. We found an association between distance to roadway
Noma: Overview of a Neglected Disease and Human Rights Violation. Noma is an orofacial gangrene affecting malnourished children and mainly observed in tropical countries, particularly sub-Saharan Africa. Epidemiological data on noma are scarce, but a current estimate of the global incidence is 30,000-40,000 cases per year, with a mortality rate of approximately 85% and a burden of disease calculated to be a loss of 1-10 million disability-adjusted life years. The etiology of noma is multifactorial with malnutrition as an ever present factor, often in combination with concomitant diseases, such as measles, malaria, and human immunodeficiency virus (HIV), and poor oral hygiene. The pathogenesis is a fast-spreading, noncontagious gangrenous infection occurring in the face, often preceded
Noma surgery. Noma is a devastating and destructive disease of the face for which there is a dearth of information regarding surgical options. Herein, we describe the facial deformities and patient characteristics in a patient population affected by noma and the surgical approaches used in treatment. Retrospective case series of a Doctors Without Borders (Médecins Sans Frontières) intervention %, n = 11), and social stigma (66.7%, n = 12). The majority (83.3%, n = 15) had lip involvement. Four patients (22.2%) underwent staged flap procedures including prelamination, flap delay, or pedicle division. The mean duration of surgical procedure was 87 minutes (range 5-306 minutes). The minor complication rate was 16%. There were no major complications or deaths. Noma is a mutilating disease
Risk factors for diagnosed noma in northwest Nigeria: A case-control study, 2017 Noma (cancrum oris), a neglected tropical disease, rapidly disintegrates the hard and soft tissue of the face and leads to severe disfiguration and high mortality. The disease is poorly understood. We aimed to estimate risk factors for diagnosed noma to better guide existing prevention and treatment strategies using a case-control study design. Cases were patients admitted between May 2015 and June 2016, who were under 15 years of age at reported onset of the disease. Controls were individuals matched to cases by village, age and sex. Caretakers answered the questionnaires. Risk factors for diagnosed noma were estimated by calculating unadjusted and adjusted odds ratios (ORs) and respective 95% confidence
Subclinical cerebrovascular disease inversely associates with learning ability: The NOMAS. Memory has been examined in subjects with imaging markers of cerebrovascular disease, but learning has been less well studied. We examined the relationship among subclinical cerebrovascular disease, cerebral volumes, and verbal learning in an ethnically and racially diverse community sample. A clinically = -1.08 to 1.00, p = 0.94). Those with greater WMHV had increased odds of a flatter learning slope. After excluding participants with SBI, the association between total words learned and WMHV remained significant. All measurements were adjusted for age, education, race/ethnicity, medical insurance status, and the presence of SBI. White matter hyperintensities, a marker of cerebral small vessel disease
Acute necrotising gingivitis in young children from villages with and without noma in Niger and its association with sociodemographic factors, nutritional status and oral hygiene practices: results of a population-based survey Previous studies have suggested that acute necrotising gingivitis precedes nomadisease and that noma clusters in some villages in certain regions of low- and middle -income countries. We sought to assess the prevalence of gingivitis with bleeding in young children from villages with or without a history of noma and to analyse epidemiological differences related to sociodemographic characteristics, nutritional status and oral hygiene practices. We conducted a cross-sectional study in 440 children aged between 2 and 6 years from four villages in the Zinder region