Treatment of Noma: medical missions in Ethiopia

McGurk, Mark; Marck, Roos E.

doi:10.1038/sj.bdj.2010.159

Cited by 13 publications

(9 citation statements)

References 7 publications

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“…DALYs averted per patient were 3.9,43 6.041 and 10.1 per patient 48. In three noma missions, a surgeon-reported outcome scale was used to score aesthetic and functional outcome 32 50 52. Overall findings showed that high-complex surgery is associated with greater risks of unsatisfactory results.…”

Section: Resultsmentioning

confidence: 97%

Impact of short-term reconstructive surgical missions: a systematic review

et al. 2019

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IntroductionShort-term missions providing patients in low-income countries with reconstructive surgery are often criticised because evidence of their value is lacking. This study aims to assess the effectiveness of short-term reconstructive surgical missions in low-income and middle-income countries.MethodsA systematic review was conducted according to PRISMA guidelines. We searched five medical databases from inception up to 2 July 2018. Original studies of short-term reconstructive surgical missions were included, which reported data on patient safety measurements, health gains of individual patients and sustainability. Data were combined to generate overall outcomes, including overall complication rates.ResultsOf 1662 identified studies, 41 met full inclusion criteria, which included 48 546 patients. The overall study quality according to Oxford CEBM and GRADE was low. Ten studies reported a minimum of 6 months’ follow-up, showing a follow-up rate of 56.0% and a complication rate of 22.3%. Twelve studies that did not report on duration or follow-up rate reported a complication rate of 1.2%. Fifteen out of 20 studies (75%) that reported on follow-up also reported on sustainable characteristics.ConclusionsEvidence on the patient outcomes of reconstructive surgical missions is scarce and of limited quality. Higher complication rates were reported in studies which explicitly mentioned the duration and rate of follow-up. Studies with a low follow-up quality might be under-reporting complication rates and overestimating the positive impact of missions. This review indicates that missions should develop towards sustainable partnerships. These partnerships should provide quality aftercare, perform outcome research and build the surgical capacity of local healthcare systems.PROSPERO registration numberCRD42018099285.

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Section: Resultsmentioning

confidence: 97%

Impact of short-term reconstructive surgical missions: a systematic review

et al. 2019

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“…30 Noma is predominantly a disease of the soft tissues resulting from bacterial toxins inducing local necrosis of both soft tissue and subsequently bone. 31 Most of the patients in this series had compromised oral health to a greater or lesser degree, and none of the cases were edentulous.…”

Section: Discussionmentioning

confidence: 97%

Sixty cases of extreme osteonecrosis and osteomyelitis of the mandible and maxilla in a West African population

Khullar

Tvedt

Chapman³

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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“…Wound care is also mandatory for noma lesions, this includes changing the dressing frequently, debridement of the wound, and sequester extraction. 2,30 Surgical management of noma sequelae is aimed at improving function and aesthetics of the face. The basic principles of surgical management include treating trismus or ankylosis and replacing the lost tissue with a flap of localized tissue or from another part of the body (especially if the tissue lost is extensive).…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

“…Latar belakang: Noma adalah gangren orofasial yang menyerang anak-anak kekurangan gizi terutama di negara-negara berkembang dan negara-negara tropis. Data epidemiologi tentang noma sangat langka, tetapi perkiraan kejadian global saat ini adalah [30][31][32][33][34][35][36][37][38][39][40].000 kasus per tahun, dengan tingkat kematian sekitar 85%. Tujuan: Membahas patogenesis, diagnosis, pencegahan, dan tatalaksana noma.…”

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Noma: Penyakit Tropis yang Terabaikan

Reksodiputro

Yosia

2021

Oto Rhino Laryn Indones

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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%. 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) followed by 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 security, improve 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 or reduce the extent of the lesions. Late treatment consists of surgical rehabilitation, which is often hard to conduct. Access to medical care are usually very limited for noma patients due to their dire socioeconomic conditions who are often located in remote rural areas. Abstrak Noma adalah gangren orofasial yang menyerang anak-anak kekurangan gizi terutama di negara-negara berkembang dan negara-negara tropis. Data epidemiologi tentang noma sangat langka, tetapi perkiraan kejadian global saat ini adalah 30-40.000 kasus per tahun, dengan tingkat kematian sekitar 85%. Penyebab noma multifaktorial, namun sering ditemukan bersamaan dengan malnutrisi dan dengan penyakit lain seperti campak, malaria, dan human immunodeficiency virus(HIV). Seringpula keadaan berada bersamaan dengan kebersihan mulut yang buruk. Patogenesis noma meliputi infeksi gangren tidak menular yang menyebar cepat yang terjadi di wajah, sering didahului oleh gingivitis nekrosis akut, dan stomatitis. Studi mikrobiologi menunjukkan infeksi oportunistik yang disebabkan oleh ketidakseimbangan mikroorganisme intraoral normal. Pencegahan terletak pada ketahanan pangan, vaksinasi campak, pencegahan malaria dan HIV, termasuk deteksi dini dan pengobatan gingivitis nekrotis dan stomatitis. Pengobatan dini dengan antibiotik dapat mencegah gangren atau mengurangi luasnya lesi. Perawatan yang terlambat terdiri dari rehabilitasi bedah, yang seringkali rumit. Akan tetapi, akses ke perawatan medis sangat terbatas bagi pasien noma karena kondisi sosioekonomi mereka yang sangat memprihatinkan yang seringkali terletak di daerah pedesaan yang terpencil.

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Treatment of Noma: medical missions in Ethiopia

Cited by 13 publications

References 7 publications

Impact of short-term reconstructive surgical missions: a systematic review

Impact of short-term reconstructive surgical missions: a systematic review

Sixty cases of extreme osteonecrosis and osteomyelitis of the mandible and maxilla in a West African population

Noma: Penyakit Tropis yang Terabaikan

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