Noma disease, also known as necrotizing ulcerative stomatitis, gangrenous stomatitis, or cancrum oris, is a fast growing and fatal infection of the mouth and face. It brings about severe tissue destruction in the face and is inclined with high morbidity and mortality. Oftentimes, the disease affects children (between the ages of two and six years old) who live in remote areas of fairly developed countries, most especially in Africa. The major causes of the disease are poor sanitation and malnutrition.
However, there are other predisposing factors, they include vitamin deficiency (most especially deficiencies of Vitamin A and Vitamin B), poor hygiene (oral hygiene especially), contaminated drinking water, living in proximity to livestock, immunodeficiency, and recent illness such as malaria, measles, diarrhea, and acute necrotizing gingivitis. Although the growth of the disease can be stopped with the use of antibiotics and improved nutrition, its physical effects remain permanent and might be repairable through oral and maxillofacial surgery or reconstructive plastic surgery.
Noma disease leads to severe facial disfigurements.
The Chief Medical Director at the Sokoto Noma Children’s Hospital, northwest, Nigeria, Dr. Shafiu Isah, has dedicated himself to the service of treating children suffering from Noma disease. According to him, many children die at home without any hospital intervention, due to poverty and lack of awareness. Also, without treatment, given that most children infected with the disease live in rural areas, about 90 percent of infected children die. This emphasizes the need for awareness concerning the disease.
The World Health Organization (WHO), according to a 1998 global estimation, recorded 140,000 new cases, and up till date, it is the most widely cited source on Noma. Most cases of the Noma disease are found in sub-Saharan Africa in children. Noma patients who survive the disease would suffer bad facial disfigurements that make it difficult to eat, speak, see or breathe, without immediate treatment. These disfigurements, in turn, most times breed stigmatization in the community and some accompanying human rights violations.
Early admission reduces the risk of death and surgical intervention.
The Chairman of the Medical Advisory Committee at Sokoto Noma Children’s Hospital, Dr. Abubakar Abdullahi Bello, stated that there have been cases whereby a patient visits the hospital and either the whole of the lower jaw is already gone or the entire nostril pathway is gone. Amidst his statement, he included that early cases presented to the hospital survive such severe issues. Early admission of Noma patients reduces the duration of their stay in the hospital and the tendency of requiring a surgical intervention.
The prevention of the disease can be achieved through basic public health interventions such as improved nutrition, improved access to routine vaccinations, and oral hygiene. Nevertheless, Nigeria, as a commitment towards eliminating the rapidly progressing disease, seeks ways to improve its awareness. The country has also, since 2016, been among 10 priority countries to be a part of the World Health Organization’s (WHO) African Regional Noma Control Program. In addition, the country aid the development of the and the implementation of the program’s national action plan for Noma prevention and control together with WHO and other partners.
WHO launched a platform for health emergencies.
The Nigerian Ministry of Health, asides it integration of Noma into its existing surveillance system, also gets funding from Doctors without Boarders, to assist in scaling up the training of primary care workers. In addition, on the July 28th, 2022, WHO launched the first WHO platform to accommodate unlimited users in case of health emergencies; it is a free and interactive Noma course, launched through OpenWHO. The course serves as a self-learning tool for health workers to improve their ability to prevent, identify, refer, and treat Noma while putting public health and human rights aspects in check.
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