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

Calleros, Héctor Manuel Prado; Castillo-Ventura, Bertha Beatriz; Jiménez-Escobar, Irma; Ramírez-Hinojosa, Juan Pablo; López−Gómez, Antonio; García-de-la-Cruz, Miguel; Dayan-Nurko, Mijal

doi:10.3855/jidc.9716

Cited by 12 publications

(8 citation statements)

References 24 publications

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“…As a result, there is a deregulation of the immune responses to oral microorganisms. All this contributes to the development of a necrotising process in the oral cavity [12,16]. The cases described in the literature have been observed in patients with advanced immunodeficiency, as was the patient we presented.…”

Section: Discussionsupporting

confidence: 57%

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First Case of Cancrum Oris (Noma) in an HIV-Positive Patient in Bulgaria

Grozdeva¹,

Strashimirov²,

Timchev³

et al. 2020

Acta Medica Bulgarica

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We present a case of a necrotising disease of the orofacial tissues, the so-called noma, in a female patient with AIDS in a stage of severe immune deficiency. To our knowledge, this is the first time a case like that has been reported in Bulgaria. The patient received an antibiotic course of treatment with a triple combination to good effect on the inflammatory process, and began also HAART. Within 3 weeks, the patient’s general condition improved. However, despite the treatment, a demarcation line was formed, and a defect on the lower lip occurred. Noma is a manifestation of severe immune deficiency with lasting adverse consequences for the patient: severe deformation of the maxilo-facial region and functional impairment (i.e. difficulties eating and speaking, and salivary leak).

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Section: Discussionsupporting

confidence: 57%

“…However, over the past two decades, there has been an increase in the incidence of noma in association with immunosuppressive therapy, and in patients with HIV infection and AIDS [4,9,10,11]. The so-called noma-like lesions are a form of the disease that occurs in immunocompromised adults, manifested by the typical orofacial lesions seen in noma [12].…”

mentioning

confidence: 99%

First Case of Cancrum Oris (Noma) in an HIV-Positive Patient in Bulgaria

Grozdeva¹,

Strashimirov²,

Timchev³

et al. 2020

Acta Medica Bulgarica

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“…The estimated mortality rate without care is 90%. This estimate is based on reports by Bourgeois et al [ 4 ], Srour et al [ 8 ], Zwetyenga et al [ 47 ], Prado-Calleros et al [ 48 ] and the recent scoping review by Farley al. [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

Economic and Social Costs of Noma: Design and Application of an Estimation Model to Niger and Burkina Faso

Mpinga

Srour²,

Moussa

et al. 2022

TropicalMed

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Background. While noma affects hundreds of thousands of children every year, taking their lives, disfiguring them and leaving them permanently disabled, the economic and social costs of the disease have not been previously estimated. An understanding of the nature and levels of these costs is much needed to formulate and implement strategies for the prevention and control of this disease, or to mitigate its burden. The objectives of our study were to develop a model for estimating the economic and social costs of noma and to provide estimates by applying this model to the specific contexts of two countries in the “noma belt”, namely Burkina Faso and Niger. Methods. Three main approaches were used. The estimation of prevalence levels of potential noma cases and of cases that should receive and actually do receive medical care was carried out using a literature review. The documentary approach made it possible to estimate the direct costs of noma by analyzing the database of a non-governmental organization operating in this field and present in both countries. Indirect costs were estimated using the human capital method and the cost component analysis technique. Results. The direct costs of care and management of noma survivors amount to approximately USD 30 million per year in Burkina Faso, compared to approximately USD 31 million in Niger. They mainly include costs for medical treatment, surgery, hospital stays, physiological care, psychological care, social assistance, schooling, vocational training and care abroad. Indirect costs are estimated at around 20 million in lost production costs in Burkina and around 16 million in Niger. Costs related to premature deaths are estimated at more than USD 3.5 billion in Burkina Faso and USD 3 billion in Niger. Finally, the costs to survivors who are unable to marry are around USD 13.4 million in Burkina and around USD 15 million in Niger. Intangible costs were not calculated. Conclusions. The neglect of noma and inaction in terms of prevention and control of the disease have enormous economic and social costs for households, communities and states. Future studies of this kind are necessary and useful to raise awareness and eradicate this disease, which impacts the health and well-being of children and results in lifelong suffering and severe economic and social costs to survivors and their families.

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“…Moreover, respiratory or diarrheal syndrome and an altered oral microbiota have been reported as potential risk factors of Noma. The HIV/AIDS pandemic increases the number of cases outside the Noma belt region and is considered to be a viable risk factor of the disease (46) (47). On the other hand, childhood vaccine coverage has been reported as a protective factor for developing the condition.…”

Section: Discussionmentioning

confidence: 99%

A mixed cross-sectional and case-control study approach to investigate the risk-factors of Noma/Cancrum oris in Ethiopia

Gebretsadik

Kiev

2022

Preprint

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Introduction Noma is a polymicrobial gangrenous facial disease affecting people living in the most impoverished areas of low- and middle-income countries. If left untreated, the disease is fatal or else severely disfigure people with the condition. The compromised immune system, poor oral hygiene, measle infection, diarrheal disease, inaccessibility to health education and proper medical care, and lack of a balanced diet and good sanitary facilities are found to be some of the predisposing factors for the development and progression of the disease. Furthermore, debilitating diseases like malaria and measles were considered as significant precursors to Noma. Materials and Method A mix of cross-sectional and case-control study approaches was conducted to assess the risk factors of Noma in Ethiopia. The raw data of the cases were obtained from Yekatik 12 Hospital, Facing Africa, and the Harar project Ethiopia. Three controls were selected per single case. The Odd ratio (ORs) and Chi-square test were calculated to rule out the statistical significance of the association observed between the factors and the disease. Results A total of 64 cases were selected for the case-control study. Considering the 1:3 case to control ratio, 192 matching controls were identified. Malaria, helminths, measle, diarrheal diseases, and living with domestic animals were found to be risk factors for Noma with a respective p-value < 0.01. Contrarily, the analysis has identified vaccination (p < 0.01) as a protective factor. Discussion Noma/face of poverty is mostly preventable by providing proper nutrition, sanitary and water facilities, awareness about the disease, oral health education, and vaccinations. Poverty-related diseases such as malaria, helminths infection, measle, diarrheal diseases, and unfavorable living conditions were identified to be the risk factor for Noma. As such the disease is truly preventable. Prevention of the disease can be achieved through promoting overall awareness of the disease, poverty reduction, improved nutrition, and promotion of exclusive breastfeeding in the first 3-6 months of life. Furthermore, optimum prenatal care, timely immunizations against common childhood diseases, initiating vaccination, and improving the social living conditions are the other preventive mechanisms. Moreover, long-lasting economic development should be considered to effectively and sustainably prevent the disease.

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

Cited by 12 publications

References 24 publications

First Case of Cancrum Oris (Noma) in an HIV-Positive Patient in Bulgaria

First Case of Cancrum Oris (Noma) in an HIV-Positive Patient in Bulgaria

Economic and Social Costs of Noma: Design and Application of an Estimation Model to Niger and Burkina Faso

A mixed cross-sectional and case-control study approach to investigate the risk-factors of Noma/Cancrum oris in Ethiopia

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