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Noma (cancrum oris): questions and answers
C O Enwonwu1, W A Falkler, E O Idigbe
1School of Dentistry, University of Maryland, Baltimore 21201, USA.
Oral Diseases
|October 16, 1999
Summary
Noma, a severe oro-facial infection, predominantly affects children in sub-Saharan Africa. Poverty, malnutrition, and poor hygiene are key risk factors, leading to high mortality and disfigurement.
Area of Science:
- Infectious Diseases
- Pediatric Health
- Global Public Health
Background:
- Noma (cancrum oris) is a devastating infectious disease causing rapid destruction of oro-facial tissues.
- It primarily affects children aged 2-16 in sub-Saharan Africa, with significant community-level frequency.
- Poverty, malnutrition, poor oral hygiene, and endemic infections like measles are critical risk factors.
Purpose of the Study:
- To summarize the epidemiology, risk factors, and pathogenesis of noma.
- To highlight the role of acute necrotizing gingivitis (ANG) as an antecedent lesion.
- To underscore the severe mortality and morbidity associated with noma.
Main Methods:
- Review of existing literature on noma.
- Analysis of epidemiological data and risk factor associations.
- Discussion of proposed microbial etiology and disease progression.
Main Results:
- Noma results from a complex interaction of general and local factors, with a weakened immune system as the common denominator.
- Acute necrotizing gingivitis is identified as the precursor lesion.
- A consortium of microorganisms, including Fusobacterium necrophorum and Prevotella intermedia, is implicated in noma's evolution.
Conclusions:
- Noma has a high mortality rate (70-90%) without prompt treatment.
- Survivors face lifelong oro-facial disfigurement and functional impairment.
- The economic burden of reconstructive surgery is prohibitive for affected populations.