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Publication

Noma: a neglected tropical disease

Abstract
Background: Noma is an orofacial gangrene often manifesting in malnourished children in developing and tropical countries. Epidemiological data on noma are hard to find, but it is estimated that the global incidence of noma is 30-40,000 cases per year, with estimated mortality rate of about 85%.
Purpose: To discuss the pathogenesis, diagnosis, prevention, and treatment of noma.
Literature review: The cause of noma is multifactorial, but is often found in conjunction with malnutrition and with other diseases such as measles, malaria, and the human immunodeficiency virus (HIV), along with poor oral hygiene. The pathogenesis of noma includes a rapidly spreading noninfectious gangrene infection of the face, often preceded by acute necrotizing gingivitis, and stomatitis. Microbiological studies show opportunistic infections caused by imbalance of normal intraoral microorganisms. The key to prevention is to increase food hygiene, improving vaccination program against measles, prevention of malaria and HIV, and early detection and treatment of necrotic gingivitis and stomatitis. Early treatment with antibiotics can prevent gangrene formation or reduce the extent of the lesions. Late treatment consists of surgical rehabilitation, which is often hard to conduct. Conclusion: Noma is an infectious disease that can cause wide gangrenous wounds. Recognizing and understanding the symptoms and characteristic signs of noma is important so that comprehensive prevention and management can be given as early and optimally as possible to provide complete recovery for patients.

More information

Type
Journal Article
Author
Reksodiputro MH
Yosia M