Why is noma a neglected-neglected tropical disease?

Srour, M. Leila; Baratti-Mayer, Denise

doi:10.1371/journal.pntd.0008435

Cited by 27 publications

(28 citation statements)

References 12 publications

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“…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 (31). Other risk factors that have been reported in several articles include the absence of breastfeeding, unsafe drinking water, limited access to high-quality health, and food security (1) (32) (33).…”

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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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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“…The estimation of the number of potential noma cases in these countries was based on (i) the scientific literature produced on the subject between 2003 and 2021 (in particular the work of Farley [ 32 , 33 , 34 ], Bello [ 35 ], Fieger [ 18 ], [ 24 , 36 ], Konsem [ 37 ], Bonkoungou [ 38 ]; and on (ii) expert opinions consulted to determine the incidence of the disease [ 3 , 8 , 18 , 24 , 32 , 34 , 35 ].…”

Section: Methodsmentioning

confidence: 99%

“…Similarly, certain social consequences of noma are often mentioned but they have not yet been explored in depth. This is the case when it comes to the social exclusion and discrimination of direct and indirect (family or households members) survivors, for which the typology forms, mechanisms of expression and courses of action have not yet been studied [ 7 , 8 ]. However, noma also has direct and visible, or indirect and less visible consequences, which affect communities as a whole.…”

Section: Introductionmentioning

confidence: 99%

“…The only public health arguments generally highlighted are related to the burden of morbidity and mortality, and moral arguments are based on the fragility of children and society’s responsibility to give them the protection they need for their development or based on the rights of the child, on human rights and therefore on the obligations of states. However, those arguments do not seem to have produced the desired effects [ 8 , 9 , 14 , 15 ]. Both economic and social consequences of noma play an important role in its burden.…”

Section: Introductionmentioning

confidence: 99%

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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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“…Epidemiologische Daten für andere orale Erkrankungen, wie orofaziales und dentales Trauma, orofaziale Spalten, Mundschleimhauterkrankungen oder Noma (Wangenbrand) sind unvollständig oder werden gar nicht koordiniert erhoben. Als Folge lässt sich deren Relevanz für die Bevölkerungsgesundheit nur schwer abschätzen (mit Ausnahme von Spalterkrankungen; [ 12 – 14 ]).…”

Section: Globale Krankheitslast Und Ungleichheiten Der Oralen Haupterkrankungenunclassified

Globale Mundgesundheit im internationalen gesundheitspolitischen Rampenlicht – Herausforderungen und neue Chancen für nachhaltige Verbesserungen

Benzian

Listl

2021

Bundesgesundheitsbl

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ZusammenfassungOrale Erkrankungen sind ein signifikantes globales Gesundheitsproblem über alle Länder und Bevölkerungsgruppen hinweg. Mit fast 3,5 Mrd. Erkrankungsfällen (2017) sind so viele Menschen betroffen wie von keiner anderen Krankheitsgruppe. Die Haupterkrankungen sind unbehandelte Karies der bleibenden oder der Milchzähne, fortgeschrittene Parodontopathien, Zahnlosigkeit sowie Karzinome der Mundhöhle und Lippen. Bei weitgehend unverändert hoher globaler Prävalenz erhöhen durch Bevölkerungswachstum bedingte stark steigende Fallzahlen den Druck auf schwache oder überlastete Gesundheitssysteme, insbesondere in Ländern der unteren und mittleren Einkommensgruppen.Dennoch wird der Mundgesundheit in vielen Ländern nur unzureichende Priorität eingeräumt und sie erhält als wichtiges Thema im gesundheitspolitischen Diskurs der deutschen und globalen Akteure nach wie vor wenig Aufmerksamkeit. Eine der fundamentalen Herausforderungen ist dabei die Gewährleistung eines allgemeinen und fairen Zugangs zu adäquater universeller Basisgesundheitsversorgung für alle Menschen ohne Verursachung von finanziellen Härten (Universal Health Coverage).Dieser Beitrag gibt einen einführenden Überblick über die globalen Trends der weltweiten Krankheitslast der oralen Haupterkrankungen, die von starken Ungleichheiten geprägt sind. Verbesserungsansätze aus der bevölkerungsweiten Risikoreduktion und Prävention, der Versorgungsplanung sowie gesundheitspolitische Lösungen werden kurz vorgestellt. Dabei werden die im internationalen Diskurs wichtigen Themen angesprochen und die im Rahmen einer Lancet-Artikelserie zur globalen Mundgesundheit aus dem Jahr 2019 entwickelten Reformbereiche besprochen. Schließlich werden neue Initiativen diskutiert sowie Empfehlungen für die deutsche und internationale gesundheitliche Entwicklungspolitik gegeben, die in den kommenden Jahren die Situation der globalen Mundgesundheit entscheidend verbessern könnten.

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Why is noma a neglected-neglected tropical disease?

Cited by 27 publications

References 12 publications

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

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

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

Globale Mundgesundheit im internationalen gesundheitspolitischen Rampenlicht – Herausforderungen und neue Chancen für nachhaltige Verbesserungen

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