NOMA

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Context: The World Health Organization (WHO) has officially added noma to its list of neglected tropical diseases (NTDs) to raise global awareness, stimulate research, secure funding, and intensify efforts to combat the disease.

About Noma

• Noma, also known as cancrum oris or gangrenous stomatitis, is a rare yet severe infection that primarily affects the soft and hard tissues of the face and mouth. This disease progresses rapidly, causing extensive tissue damage and, if left untreated, can lead to death in up to 90% of cases.

Origins and Progression

• It typically begins as a small ulcer within the mouth, commonly appearing on the gums. This often happens following an illness like measles, which weakens the immune system, leaving the body vulnerable to infections. From this initial ulcer, Noma swiftly advances, causing rapid and massive tissue destruction, eventually exposing the facial bones.

Symptoms and Pain

• Noma is incredibly painful and can cause additional symptoms like fever, foul breath, weight loss, and challenges in eating and speaking.
• The severity of the pain and the progression of the disease can significantly impact an individual's well-being.

Survivor Consequences

• Even if someone survives Noma, they may face enduring consequences. These include permanent disfigurement, disabilities, and social stigmatization.
• Functional impairments related to chewing, swallowing, breathing, and sensory perceptions such as hearing and vision might persist.

Demographics at Risk

• The disease primarily targets children aged 2 to 6 years old, especially those living in extreme poverty. These children often lack access to adequate food, clean water, sanitation, and healthcare facilities.
• Noma is most prevalent in regions plagued by malnutrition, infectious diseases, and socio-economic challenges, particularly in sub-Saharan Africa, Asia, and Latin America.

Preventive Measures

• Preventing Noma involves improving living conditions and healthcare access for vulnerable populations. This includes ensuring proper nutrition, immunization, oral hygiene practices, and sanitation measures.
• Early detection and swift medical intervention are vital in reducing mortality and complications associated with the disease.

Treatment Approaches

• Treatment for Noma typically involves antibiotic therapy to fight infection, wound care, pain management, and nutritional support.
• Surgical interventions might be necessary to remove dead tissues and reconstruct facial structures. However, accessibility to these interventions is often hampered due to socio-economic challenges faced by affected communities.

Urgent Need for Action

• Data and Awareness Gap: Accurate and updated data regarding the prevalence and distribution of Noma is crucial for effective intervention. There's also a profound lack of awareness about Noma among healthcare workers and communities, contributing to delayed diagnosis and inadequate treatment.
• Research and Intervention: Increased research efforts are essential to better comprehend the disease's causes and mechanisms, facilitating the development of more effective drugs and preventive measures. Urgent action is needed to provide training, resources, and awareness campaigns for Noma prevention, early diagnosis, and treatment.

Conclusion

• The recognition of Noma as a neglected tropical disease underscores the urgency of addressing this devastating health challenge. With increased awareness, research, and resources, global efforts can be mobilized to tackle Noma, offering hope for the affected populations and contributing to the broader goal of achieving universal health coverage.