Medical experts claim that the widespread malnutrition in Nigeria’s north-western area is to blame for the spread of the deadly and little-known face-eating sickness. Noma, also known as ”Cancrum Oris”, is a fatal gangrenous illness that causes extensive tissue loss in the face and is linked to high morbidity and death. It is mainly primarily observed in young children who reside in isolated regions of less developed nations, especially in Africa. Noma sequelae are currently affecting 770,000 people, according to a conservative assessment of the disease’s prevalence.
One of the known causes of Noma is malnutrition, according to Dr. Sherlock, who also notes that it primarily affects persons with weak immune systems who live in extreme poverty without access to clean water or medical services. They constitute the disease’s risk factors taken as a whole. Gingivitis, or gum inflammation in medical parlance, is the initial symptom of Noma illness. It eventually proceeds to “necrotizing gingivitis,” in which the oral tissues quickly begin to degenerate. The condition then worsens to the point where the afflicted person’s face begins to enlarge.
Once the face starts swelling the disease is reaching a critical level.
According to Dr. Sherlock, when the face begins to enlarge, the disease has advanced to a serious stage. Without treatment, the disease will consume the affected person’s facial tissues. At that point, the infection is nearly fatal, and even if the victim survives, they will have severe facial scars and abnormalities, making it difficult for them to eat when their jaws become locked. Dr. Sherlock continues that the patient can only open their mouths a few centimeters. Noma affects both children and adults in the same way, but it is more prevalent in kids between the ages of two and seven. According to Dr. Sherlock, children catch it during the weaning phase.
Noma can spread to infants who are weaned off breast milk and begin eating solid food that has been prepared in unhygienic conditions. Almost 90% of youngsters who contract the virus pass away within days. Noma is more common in the northwest of Nigeria, where MSF has detected previously unheard-of numbers of malnutrition cases, particularly in children. Infections with malaria and the measles are two more risk factors for Noma, according to Dr. Sherlock, who also notes that there may be other unknown risk factors.
There is a Noma treating clinic in Sokoto state.
Nigeria decided to open a Noma clinic in Sokoto state in 1999 due to the high prevalence of Noma in the region’s northwest. In 2014, MSF started funding the clinic. In its early stages, Noma is treated by doctors by cleaning the mouth and gums and administering antibiotics to infected people. According to Dr. Sherlock, reconstructive surgery may be used as a treatment when Noma reaches severe stages. It may take up to 10 reconstructive procedures for people to fully recover. Each year, MSF conducts four Noma interventions where they provide reconstructive procedures for 120–150 affected individuals. Surgical teams have performed 1,066 procedures on 717 patients thus far, but these numbers do not take the disease’s infection rate into consideration.
Due to the Noma’s abnormally high fatality rate among rural communities, statistics and data about cases and fatality rates are not quantifiable. Dr. Sherlock points out that 90% of afflicted persons pass away from the illness before receiving appropriate medical care. He claims that the condition is also little understood, which understates the number of instances. Because of this, the sickness is sometimes misclassified as another illness, such as necrosis or cancer, and cases are not accurately recorded as Noma since people are unaware of Noma, he claims. After successful procedures, MSF teams release patients with post-op care kits that include post-operative dietary supplementation. We send patients home with nutrition kits since these patients would require nutrients to recuperate properly after surviving Noma, according to Dr. Sherlock.
The WHO has launched disease control and preventive programs.
MSF is currently pleading with the World Health Organization (WHO) to include the fatal Noma on the list of neglected tropical diseases (NTDs). The disease’s inclusion on the list would raise awareness of it and the methods for preventing it. Neglected Tropical Diseases are a group of illnesses that are claimed to impact low-income populations disproportionately. The WHO has launched disease control and preventive programs in endemic areas and taken moves toward public health approaches against NTDs throughout the past ten years. MSF reported that a representative from the Federal Ministry of Health of Nigeria submitted the Noma dossier with WHO officials in Abuja, Nigeria’s capital, following a three-year global advocacy and communication campaign. The WHO will make the ultimate decision on whether to include Noma on its list of neglected tropical illnesses during one of its biennial sessions in 2023, according to a news release from MSF.
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