WHAT IS NOMA?
(derived from the Greek "nomein" meaning "to
devour") is a devastating gangrenous disease which
attacks children, quickly destroying their mouth, nose,
and face, and which can prove fatal after just a few
weeks. Noma, also known as cancrum oris, seems to start
on the gum and extends outwards to the cheeks and lips.
Without prompt treatment, mortality rates from this
disease are as high as 70-90%, with most deaths attributed
to complications such as pneumonia, diarrhea and septicemia.
common predecessor to noma is Acute Necrotizing Gingivitis
(ANG), one of the relatively severe forms of inflammation
of the gum margin between the teeth. ANG and noma occur
most frequently in poor children whose immunity is compromised
as a result of severe malnutrition and endemic infections,
particularly malaria and infections by the measles virus,
the human cytomegalovirus, Epstein-Barr virus, and herpes
simplex virus, among others.
early features of noma include soreness of the mouth,
a swollen tender cheek, a foul-smelling purulent oral
discharge, fetid odor in the mouth of the affected child,
swelling of the regional lymph nodes, anorexia, and
a grayish-black discoloration of the skin in the affected
area. The long-term effects of Noma depend largely on
the anatomic sites of the lesion, the extent and severity
of tissue destruction and the stage of development of
the dentition and facial skeleton prior to onset of
of the disease suffer the dual problems of facial disfigurement
and associated functional impairment, such as difficulty
in eating, drinking, and speaking. Surgical Reconstruction
of the deformity is time-consuming as well as expensive,
rarely available or affordable in the areas where it
is most needed, and can only repair part of the damage.
Therefore prevention of the disease is the best option.
Noma survivors are disfigured for life, and are commonly
shunned by their communities, relegated to a life with
little social or emotional comfort or support. They
carry the burden of being the face of poverty for a
attacks children 2-14 years old.
accounts for the majority of the cases.
World Health Organization estimates that 100,000 children
contract noma every year.
treatment, the mortality rate is 70-90%.Most
victims starve to death because their jaw muscles are
literally eaten away and they cannot chew; others die
as the infection spreads.