Noma (disease)

Noma (from Greek numein: to devour) also known as cancrum oris or gangrenous stomatitis, is a gangrenous disease leading to tissue destruction of the face, especially the mouth and cheek.^{[1] [2]}

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Causes

Noma may be caused by bacteria called fusospirochetal organisms. Many children who develop the disease have had another illness such as measles, scarlet fever, tuberculosis, cancer, or immunodeficiency. Although the exact cause is not known, poor nutrition is a risk factor for the disease. It is not communicable.

History

Known in antiquity to such physicians as Hippocrates and Galen, Noma was once reported around the world, including Europe and the United States. With the improvement in hygiene and nutrition, noma has disappeared from industrialized countries since the 20th Century, except during World War II when it was endemic to Auschwitz (in the section where the Nazis interned Gypsies) and Belsen.[1]

Presentation and prognosis

The mucous membranes of the mouth develop ulcers, and rapid, painless tissue degeneration ensues, which can degrade tissues of the bones in the face.^[3] The disease degrades the faces of children within days.

In a condition sometimes called noma pudendi, noma can also cause tissue damage to the genitals.

The disease is associated with high morbidity and mortality (of around 80 per cent)[2] and mainly affects children under the age of twelve in the poorest countries of Africa. Children in Asia and some countries of South America are also affected. Most children who get the disease are between the ages of two and six years old.^[4] The WHO estimates that 500,000 people are affected with 100,000 new cases each year.

Treatment

The disease is rarely treated since in some cultures it is considered taboo.^{[citation needed]}

Despite the fact that more than 400,000 children are affected in Africa alone, there is only one noma hospital in all of Africa. Noma Children Hospital Sokoto is located in Nigeria and aside from the regular doctors, European and American medical teams travel there to perform operations. Without plastic surgery, the children's faces cannot be restored.

References

1. ^ Enwonwu CO (2006). "Noma--the ulcer of extreme poverty". N. Engl. J. Med. 354 (3): 221-4. doi:10.1056/NEJMp058193. PMID 16421362.
2. ^ Enwonwu CO, Falkler WA, Phillips RS (2006). "Noma (cancrum oris)". Lancet 368 (9530): 147-56. doi:10.1016/S0140-6736(06)69004-1. PMID 16829299.
3. ^ AllRefer Health - Noma (Cancrum Oris, Gangrenous Stomatitis). Retrieved on 2007-07-12.
4. ^ The European Noma-Network. Retrieved on 2007-07-12.