Noma (cancrum oris)
is a devastating, gangrenous disease leading to severe tissue
destruction in the face and associated with high morbidity and
mortality. It is observed almost exclusively in young children
living in remote areas of developing countries, particularly Africa.
The exact prevalence of the disease is unknown
but it has been conservatively estimated that 770,000 persons
are currently affected by noma sequelae. The causal origin remains
unknown but a combination of several elements of a plausible aetiology
have been identified: malnutrition, a compromised immune system,
poor oral hygiene and a lesion of the gingival mucosal barrier,
and an undetermined bacterial factor acting as a trigger for the
disease.
The epidemiology, clinical aspects, current
understanding of the pathophysiology, and treatment of the acute
phase and sequelae requiring reconstructive surgery are reviewed
in the article below. Noma may be preventable if recognised at
an early stage but further research is required to determine more
exactly the causative agents.
Download the complete
article "Noma: an "infectious" disease of unknown
aetiology" , GESNOMA 2003
[Download]
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