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Noma staging: a review.

Razia Abdool Gafaar Khammissa1, Johan Lemmer2, Liviu Feller3

  • 1Department of Periodontics and Oral Medicine, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. razia.khammissa@up.ac.za.

Tropical Medicine and Health
|June 13, 2022
PubMed
Summary

Noma, a destructive oro-facial disease, primarily affects malnourished children in impoverished regions. This viewpoint proposes a revised staging system for noma to improve epidemiological data quality.

Keywords:
Acute nomaArrested nomaNecrotising gingivitisNecrotising periodontitisNecrotising stomatitisNoma classification

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Infectious Diseases
  • Public Health

Background:

  • Noma is a severe, necrotizing oro-facial disease predominantly affecting malnourished children in resource-limited areas.
  • It is a bacterial, non-communicable condition, often linked to debilitating illnesses and immunosuppression in regions like sub-Saharan Africa.

Purpose of the Study:

  • To critically evaluate the existing World Health Organization (WHO) classification of noma.
  • To propose a revised, evidence-based staging system for noma that is simpler, more logical, and practical.

Main Methods:

  • This is a viewpoint article, not based on new experimental data.
  • The authors analyze the current WHO staging system and its limitations.
  • A new staging proposal is presented based on clinical and epidemiological considerations.

Main Results:

  • The current WHO classification of noma into five stages (gingivitis, oedema, gangrene, scarring, sequela) is deemed inadequate.
  • The proposed revised staging aims to enhance the accuracy and utility of future noma research.

Conclusions:

  • The existing WHO staging system for noma requires significant re-appraisal.
  • A new, practical staging system for noma is proposed to improve the quality of epidemiological data and guide future research.