@article{97051,
  keywords = {Infectious Diseases, Public Health, Environmental and Occupational Health},
  author = {Khammissa RAG and Lemmer J and Feller L},
  title = {Noma staging: a review},
  abstract = {<p>Noma is a bacterial, non-communicable, grossly destructive and disfiguring necrotising oro-facial disease. It is rare, but occurs most commonly in chronically malnourished children with other debilitating illnesses, in remote, poverty-stricken communities, mainly in sub-Saharan Africa, and much more rarely in central Latin America and in parts of Asia. In South Africa and in Zimbabwe, noma is observed, again rarely, in immunosuppressed HIV-seropositive subjects. The World Health Organization (WHO) has classified noma into five sequential stages: stage 1, acute necrotising ulcerative gingivitis; stage 2, oedema; stage 3, gangrene; stage 4, scarring; stage 5, sequela. In the opinion of the authors, this WHO classification requires fundamental re-appraisal. The purpose of this viewpoint article is to highlight the weaknesses of this classification, and to propose a simpler, more logical and practical evidence-based staging of noma, which if used should improve the quality and value of future epidemiological data about noma.</p>
},
  year = {2022},
  journal = {Tropical Medicine and Health},
  volume = {50},
  publisher = {Springer Science and Business Media LLC},
  issn = {1349-4147},
  url = {https://tropmedhealth.biomedcentral.com/track/pdf/10.1186/s41182-022-00431-6.pdf},
  doi = {10.1186/s41182-022-00431-6},
  language = {eng},
}