HQ Team
December 21, 2023: The WHO, has included noma in its official list of neglected tropical diseases to expand health services to the world’s most vulnerable populations.
Noma, also known as cancrum oris or gangrenous stomatitis, is a severe gangrenous disease of the mouth and face.
It affects malnourished young children between the ages of two and six years in regions of extreme poverty.
The neglected tropical disease (NTD) starts as an inflammation of the gums, which, if not treated early, spreads quickly to destroy facial tissues and bones.
Disfigurement
It frequently leads to death, with survivors suffering severe disfigurement. Cases of noma are mostly found in sub-Saharan Africa, although cases have also been reported in the Americas and Asia.
“Noma is more than a disease, it is a social marker of extreme poverty and malnutrition, affecting the most vulnerable populations,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
“By classifying noma as a neglected tropical disease, we are shining a light on a condition that has afflicted marginalised communities for centuries.”
Evidence indicates that noma is caused by bacteria found in the mouth, according to a WHO statement.
Oral hygiene
There are multiple risk factors associated with this disease, including poor oral hygiene, malnutrition, weakened immune systems, infections, and extreme poverty.
Noma is not contagious but tends to strike when the body’s defences are down.
Early detection is essential, as therapy is most effective at the early stages of disease when it causes severe swollen gums, known as acute necrotizing gingivitis.
Treatment involves antibiotics, advice and support on practices to improve oral hygiene with disinfectant mouthwash and nutritional supplements.
If diagnosed during the early stages of the disease, treatment can lead to proper wound healing without long-term consequences.
In severe cases, surgery may be necessary.
Social stigma
Children who survive the gangrenous stage of the disease are likely to suffer severe facial disfigurement, have difficulty eating and speaking, face social stigma and isolation, and need reconstructive surgery.
The Government of Nigeria spearheaded action to have noma included in the list of NTDs.
In January 2023, an official request was submitted to WHO on behalf of 32 Member States.
The request was supported by a detailed dossier highlighting the burden and distribution of noma and providing evidence to demonstrate fulfilment of the criteria set by WHO.
The formal process for adding new conditions to the NTD list was established by the STAG-NTD in 2016.
The WHO’s NTD list includes 21 diseases or groups of diseases.
