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Not to be confused with Noma neonatorum.
Noma
Noma.png
A man afflicted with noma
Classification and external resources
ICD-9-CM 528.1
MedlinePlus 001342
MeSH D009625

Noma (also referred to as cancrum oris, fusospirochetal gangrene, necrotizing ulcerative stomatitis, stomatitis gangrenosa)[1] is a rapidly progressive, polymicrobial, often gangrenous infection of the mouth or genitals.

Causes[edit]

Fusobacterium necrophorum and Prevotella intermedia are thought to be key players in the process and interact with one or more other bacterial organisms (such as Borrelia vincentii, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Staphylococcus aureus, and nonhemolytic Streptococcus spp).[2]

The reported predisposing factors include:[3][4]

  • malnutrition (particularly A-and B-vitamins) or dehydration
  • poor hygiene, particularly oral
  • unsafe drinking water
  • proximity to unkempt livestock
  • recent illness
  • an immunodeficiency disease, including AIDS

Presentation[edit]

The mucous membranes of the mouth develop ulcers, and rapid, painless tissue degeneration ensues, which can degrade tissues of the bones in the face.[5]

In a condition sometimes called noma pudendi, noma can also cause tissue damage to the genitals.

Prognosis[edit]

The disease is associated with high morbidity and mortality[6] and mainly affects children under the age of twelve in the poorest countries of Africa. Children in Asia and some countries of South America are also affected. Most children who get the disease are between the ages of two and six years old.[7] The WHO estimates that 500,000 people are affected, and that 140,000 new cases are reported each year.[8] The mortality rate is approximately 90 percent.[1]

Treatment[edit]

Known in antiquity to such physicians as Hippocrates and Galen, noma was once reported around the world, including Europe and the United States. With improvements in hygiene and nutrition, noma has disappeared from industrialized countries since the 20th century, except during World War II when it was endemic to Auschwitz and Belsen concentration camps.[9] The disease and treatments were studied by Berthold Epstein, a Czech physician and forced-labor prisoner who had recommended the study under Josef Mengele's direction.[9]

The progression of the disease can be halted with the use of antibiotics and improved nutrition; however, its physical effects are permanent and may require oral and maxillofacial surgery or reconstructive plastic surgery to repair. Reconstruction is usually very challenging and should be delayed until full recovery (usually about one year following initial intervention). [10]

Children and other noma survivors in Africa are helped by a few international charitable organizations, such as Facing Africa, a UK registered charity that helps Ethiopian sufferers. There is one dedicated noma hospital in Nigeria, the Noma Children Hospital Sokoto, staffed by resident and visiting medical teams. In other countries, such as Ethiopia, international charities work in collaboration with the local health care system to provide complex reconstructive surgery which can give back facial functions such as eating, speaking and smiling. Teams of volunteer medics coming from abroad are often needed to support the local capacity to address the most severe cases, which can be extremely challenging even for senior maxillofacial surgeons.[11] On 10 June 2010 the work of such volunteer surgeons was featured in a UK BBC Two documentary presented by Ben Fogle, Make Me a New Face: Hope for Africa's Hidden Children.[12][13]

References[edit]

  1. ^ a b Marck, KW (2003). "A history of noma, the "Face of Poverty" (abstract)". Plast Reconstr Surg 111 (5): 1702–7. doi:10.1097/01.PRS.0000055445.84307.3C. PMID 12655218. 
  2. ^ Neville, Brad. Oral and Maxillofacial Pathology (3rd ed.). Saunders Book Company. pp. 062008. 5.11. 
  3. ^ Enwonwu CO (2006). "Noma--the ulcer of extreme poverty". N. Engl. J. Med. 354 (3): 221–4. doi:10.1056/NEJMp058193. PMID 16421362. 
  4. ^ Enwonwu CO, Falkler WA, Phillips RS (2006). "Noma (cancrum oris)". Lancet 368 (9530): 147–56. doi:10.1016/S0140-6736(06)69004-1. PMID 16829299. 
  5. ^ "AllRefer Health - Noma (Cancrum Oris, Gangrenous Stomatitis)". Retrieved 2007-07-12. 
  6. ^ Barmes DE, Enwonwu CO, Leclercq MH, Bourgeois D, Falkler WA (1997). "The need for action against oro-facial gangrene (noma)". Trop Med Int Health 2: 1111–1114. doi:10.1046/j.1365-3156.1997.d01-220.x. 
  7. ^ "The European Noma-Network". Retrieved 2007-07-12. 
  8. ^ Bourgeois DM, Leclercq MH (1999). "The World Health Organization initiative on noma". Oral Dis 5: 172–174. doi:10.1111/j.1601-0825.1999.tb00085.x. 
  9. ^ a b Lifton, Robert Jay (1986). The Nazi Doctors: Medical Killing and Psychological Genocide. Basic Books. p. 361. ISBN 0-465-04905-2. 
  10. ^ Neville, Brad. Oral and Maxillofacial Pathology, 3rd Edition. Saunders Book Company, 062008. 5.11.2
  11. ^ Project Harar - Medical care
  12. ^ Make Me a New Face: Hope for Africa's Hidden Children at bbc.co.uk
  13. ^ Ben Fogle » Blog Archive » Ben’s Documentary on Noma - BBC2

Further reading[edit]

The Surgical Treatment of noma by Kurt Boss and Klaas Marck. ISBN 978-90-71736-31-5

External links[edit]


Original courtesy of Wikipedia: http://en.wikipedia.org/wiki/Noma_(disease) — Please support Wikipedia.
This page uses Creative Commons Licensed content from Wikipedia. A portion of the proceeds from advertising on Digplanet goes to supporting Wikipedia.
1421 videos foundNext > 

Hilfsaktion Noma - The Face of Poverty

This is the new movie from Hilfsaktion Noma about the disease noma and how we help the children affected by this crual bacterial infection. For further ...

Noma - The Disease Of Poverty

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NOMA disease trailer

NOMA Disease Kills 100.000 every year! - Ben Fogle BBC2

THE SOLUTION --- http://www.equalmoney.org http://www.facebook.com/jjesusmusic --- MUSIC FOR EQUALITY Noma kills more than 100.000 people every ...

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NOMA DISEASE

http://www.facingafrica.org/FA08/content/site/en/pages/homepage/default.asp.

NOMA

"Noma (cancrum oris) is an acute and ravaging gangrenous infection affecting the face. The victims of Noma are mainly children under the age of 6, caught in a ...

NOMA - Make Me A New Face - Part 1

Make Me A New Face - Hope For Africa's Hidden Children - Part 1 A BBC documentary featuring the work of Facing Africa in Ethiopia.

1421 videos foundNext > 

19 news items

New Vision

DAWN.com
Sat, 04 Jul 2015 03:52:50 -0700

ZINDER: Mourdja's nose has been eaten away, like one lip and part of her upper gum, leaving the 13-year-old girl atrociously disfigured by noma, a disease that thrives on malnutrition. “It was better before,” the teenager says shyly and simply in the ...

China Post

China Post
Mon, 06 Jul 2015 10:37:30 -0700

Desperate Gazans resort to makeshift homes a year after the war with Israel. A health worker takes care of a young girl with Noma disease in a health center run by the NGO Sentinelles in Zinder, Niger on May 26. (AFP) Enlarge Photo ...
 
Axis of Logic
Tue, 17 Aug 2010 03:50:47 -0700

The following article is based on a report “The tragedy of Noma 1”, prepared by Mr. Jean Ziegler, Vice-President of the UN Human Rights Council Advisory Committee. Unless otherwise noted, the quotes in this article are excerpted from this report by Mr.

BBC News

BBC News
Tue, 27 Jan 2015 16:07:38 -0800

In another experiment, she says, the pair of them and more than 100 other twins were given injections of bacteria that cause Noma disease - an infection of the mouth or genitals, which causes boils and often turns gangrenous. Some twins became feverish ...

Le Huffington Post Quebec

Le Huffington Post Quebec
Fri, 19 Jun 2015 15:20:33 -0700

Son nez a disparu, tout comme sa lèvre et une partie de sa gencive supérieure, pour laisser place à une atroce béance : Mourdja, 13 ans, est défigurée par le noma, "maladie de la misère" causée par la malnutrition, très présente au Niger. "Avant, c ...

Manchester Evening News

Manchester Evening News
Sat, 24 Aug 2013 00:03:29 -0700

It's hard to believe that 24-year-old Sikyh Richardson, relaxing in her bikini in Marbella this summer, nearly lost her life four times to a devastating illness. Share; Share; Tweet; +1; LinkedIn. STUNNING: Silkyh steps out in Marbella. Stepping out ...
 
CBS News
Wed, 24 Oct 2012 14:32:35 -0700

WARSAW, Poland The images are haunting: naked and emaciated children at Auschwitz standing shoulder-to-shoulder, adult prisoners in striped garb posing for police-style mug shots. Wilhelm Brasse, Auschwitz, prisoner, holocaust. This photograph ...

Lancashire Telegraph

Lancashire Telegraph
Fri, 16 Aug 2013 14:04:55 -0700

Bill Hamlin, consultant anaesthetist at East Lancashire Hospitals NHS Trust, will visit Ethiopia with a team surgeons and nurses to perform reconstructive surgery on patients suffering from noma disease – an extreme infection which severely disfigures ...
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