Noma: A disease of poverty presenting at an urban hospital in the United States

Maley, Alexander; Desai, Mihir J.; Parker, Sareeta

doi:10.1016/j.jdcr.2014.10.001

Cited by 17 publications

(21 citation statements)

References 8 publications

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“…These can result in multiple physical impairments such as difficulty speaking, swallowing, eating, seeing and breathing which can lead to stigmatization in their communities [ 4 ]. Noma is thought to be most prevalent along the noma belt which stretches from Senegal to Ethiopia [ 4 ], however noma cases have recently been reported in the United Kingdom [ 5 ], United States [ 6 ], Afghanistan [ 7 ], South Korea [ 8 ] and Laos [ 9 ]. A northwest Nigerian based study concluded that the incidence of noma is estimated to be 6.4 per 1000 children [ 10 ], and the World Health Organization (WHO) estimates that 140 000 children contract noma each year globally [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Previous observational studies have suggested that risk factors for development of noma include malnutrition, low birthweight, absence of breastfeeding, poor oral hygiene, co-morbidities, proximity of livestock to area of residence, large family size, access to unsafe drinking water and living in a village with a high prevalence of acute necrotising gingivitis [ 4 , 11 – 13 ]. Recently, an increased incidence of noma has been reported in higher resource settings in patients with immunosuppressive diseases such as human immunodeficiency virus (HIV) [ 5 , 6 , 8 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for diagnosed noma in northwest Nigeria: A case-control study, 2017

et al. 2018

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BackgroundNoma (cancrum oris), a neglected tropical disease, rapidly disintegrates the hard and soft tissue of the face and leads to severe disfiguration and high mortality. The disease is poorly understood. We aimed to estimate risk factors for diagnosed noma to better guide existing prevention and treatment strategies using a case-control study design.MethodsCases were patients admitted between May 2015 and June 2016, who were under 15 years of age at reported onset of the disease. Controls were individuals matched to cases by village, age and sex. Caretakers answered the questionnaires. Risk factors for diagnosed noma were estimated by calculating unadjusted and adjusted odds ratios (ORs) and respective 95% confidence intervals (CI) using conditional logistic regression.FindingsWe included 74 cases and 222 controls (both median age 5 (IQR 3, 15)). Five cases (6.5%) and 36 (16.2%) controls had a vaccination card (p = 0.03). Vaccination coverage for polio and measles was below 7% in both groups. The two main reported water sources were a bore hole in the village (cases n = 27, 35.1%; controls n = 63, 28.4%; p = 0.08), and a well in the compound (cases n = 24, 31.2%; controls n = 102, 45.9%; p = 0.08). The adjusted analysis identified potential risk and protective factors for diagnosed noma which need further exploration. These include the potential risk factor of the child being fed pap every day (OR 9.8; CI 1.5, 62.7); and potential protective factors including the mother being the primary caretaker (OR 0.08; CI 0.01, 0.5); the caretaker being married (OR 0.006; CI 0.0006, 0.5) and colostrum being given to the baby (OR 0.4; CI 0.09, 2.09).InterpretationThis study suggests that social conditions and infant feeding practices are potentially associated with being a diagnosed noma case in northwest Nigeria; these findings warrant further investigation into these factors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for diagnosed noma in northwest Nigeria: A case-control study, 2017

et al. 2018

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“…Noma occurs worldwide, and although the mayor incidence of noma corresponds to the geographical distribution of poverty, with most cases reported in Africa, it should not be considered as solely a disease of the developing world; the World Health Organization has received reports of sporadic cases of noma-like disease in adults, from higher-income countries, including North America and Western Europe countries, almost always associated with disorders of the immune system like AIDS in association with human immunodeficiency virus (HIV) infection [1][2][3][4][5][7][8][9][10]. The exact incidence of noma-like disease in adults is unknown [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…Differential diagnosis for noma includes clostridial or streptococcal gangrene, ecthyma gangrenosum, necrotizing fasciitis, leprosy, leishmaniasis, mucormycosis, extranodal natural killer/T-cell lymphoma and oral cancer [3,9].…”

Section: Introductionmentioning

confidence: 99%

Noma and Noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review

Calleros

Castillo-Ventura

Jiménez-Escobar

et al. 2018

J Infect Dev Ctries

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Introduction: Noma is an opportunistic polymicrobial infection that cause necrosis of the mouth and face, with high morbidity and mortality, predominantly affecting malnourished children and persons with debilitating diseases. Cases of noma-like disease in adults, although rare, have been increasingly reported in HIV/AIDS patients particularly in developing countries but also in more developed countries. Methodology: A systematic review of the literature to assess the occurrence and clinical impact of noma and noma-like disease in HIV/AIDS patients was performed on PubMed, Virtual Health Library, Cochrane Library and Google Scholar using the keywords "HIV"[ All Fields] AND "Noma"[All Fields] in December 2016 (years includead for the search: 1985 to 2016). Results: Twenty-four published studies were identified that document the occurrence of noma or noma-like disease in a total of 133 HIV/AIDS children and adult patients in the last 22 years. Although HIV infection is not the principal risk factor for noma, in some regions may play a substantial role in its pathogenesis. The mortality rate for noma-like disease in HIV/AIDS patients was 54.3%, compared to the 15% mortality rate of treated noma patients without HIV/AIDS. Most of the cases have never been on antiretroviral therapy, and their HIV infection was discovered because of the noma-like disease. Conclusions: The syndemic interaction between HIV/AIDS and noma-like disease adversely impacts the severity of the disease and the mortality rate. Noma-like disease, although not yet considered a specific or frequent disease associated with HIV infection, should be considered as an opportunistic infection for AIDS.

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“…Factors such as malnutrition, weak immune function, and previous viral infections, are caused by poor oral hygiene (Hatcher & Williamson, 2017;Lee et al, 2017;Maley, Desai, & Parker, 2015). The results showed that the majority of Korowai tribe children never brush their teeth (73.91%).…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Investigation of Noma in Papua Province in 2017

Kaimudin

Hidajah

2020

JBE

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Background: Indonesia Ministry of Health in October 2017 obtained information from the Public Health Emergency Operation Center (PHEOC) that there allegations of noma case in a toddler from the Korowai tribe in Asmat District. Purpose: This study aims to describe the magnitude of the noma problem, identify risk factors, and find other noma cases for prevention and control. Methods: This was a descriptive study using a case study approach. Primary data was obtained from interviews with family or close relatives of patients to obtain information about patient identity, medical history, and risk factors. Measurement of nutritional status and oral health was done by measuring weight or height and checking their oral health. Secondary data was obtained from Asmat District health office (Dinkeskab Asmat) and Yaniruma Health Center. The data analyzed were geographical, demographic, socio-cultural, transportation, and communication condition. Results: Noma sufferer was a 5-years-old child who lived in Afimabul village. There was not other cases of Noma found in Korowai tribal community. A long distance to reach health services and no availability of communication tools to Korowai tribe in Afimabul village made them inaccessible. The results of the identification of risk factors in 46 children found that the majority of them had low oral hygiene (73.91%) and consumed uncooked water (80.43%). Besides, some had an index of thin body weight (15.22%), and very lean (6.52%), and also found the suspected measles. Conclusion: There was only one case found in the Asmat district. Moreover, there were still found Korowai children with thin and very lean nutritional status and suspected measles who are risk factors for noma.

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Noma: A disease of poverty presenting at an urban hospital in the United States

Cited by 17 publications

References 8 publications

Risk factors for diagnosed noma in northwest Nigeria: A case-control study, 2017

Risk factors for diagnosed noma in northwest Nigeria: A case-control study, 2017

Noma and Noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review

Epidemiological Investigation of Noma in Papua Province in 2017

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