WHERE DOES NOMA OCCUR?

Noma can strike any community where poverty, malnutrition and infections are prevalent, and should not therefore be regarded as solely a disease of the developing world, as is all too often the case. Both genders are affected, and although it can be seen in adults, it is predominantly a disease of young children between 2 and 16 years of age, with a peak incidence around ages 1 and 4.

Noma virtually disappeared from developed countries during the 20th Century except for isolated cases reported in the concentration camps of Bergen-Belsen and Auschwitz, and more recently, in patients with HIV infection/AIDS, as well as in Native American children with underlying Severe Combined Immunodeficiency Syndrome (SCID). In developing countries, particularly in sub-Saharan Africa, noma is an escalating public health scourge of economically disadvantaged communities. The victims are generally malnourished children residing under deplorable environmental/sanitary conditions and often in close proximity to livestock.

Worldwide, the number of children under 6 years of age who contract Noma is estimated to be several hundred thousands per year. Estimates of Noma incidence per 1000 children aged birth to 6 years for Niger, Nigeria and Senegal are 1.34, 0.80 and 0.7-1.2 respectively.