WHO Recognizes Noma as Neglected Tropical Disease

December 20, 2023

On December 15, 2023, the World Health Organization (WHO) officially included noma, a severe gangrenous disease of the mouth and face, in its list of neglected tropical diseases (NTDs). Also known as cancrum oris, noma has a high mortality rate of approximately 90%, and it is associated with extreme poverty, malnutrition, and poor sanitation.

Overview of Noma

Alias: Cancrum oris, gangrenous stomatitis.
Demographic Impact: Primarily affects children aged 2-6 years, prevalent in poor communities.
Mortality Rate: Around 90% if not treated early.
Risk Factors: Poor oral hygiene, malnutrition, weakened immune systems, infections, and extreme poverty.
Origins of the Name: Derived from the Greek word “nomē,” meaning “to devour,” reflecting its destructive nature.

Hidden Nature and Lack of Awareness

Limited Data: Lack of reliable numbers; WHO estimates date back to 1998, with 140,000 cases per year and a prevalence of 770,000 cases.
Neglected Aspect: The disease affects marginalized children, contributing to its hidden or neglected nature.

Association with Poverty

‘Face of Poverty’: Inaccessibility to effective drugs and surgical treatments due to extreme poverty.
Historical Impact: Common in the Western world in previous centuries, but economic progress led to its disappearance.

Symptoms and Consequences

Starts as Ulcer: Often begins as an ulcer on the mucous membrane after diseases like measles.
Rapid Necrosis: Develops into massive necrosis, involving major portions of the face.
Consequences: Facial disfigurement, jaw muscle spasm, oral incontinence, speech problems.

Treatment and Eradication

Early Detection Crucial: High mortality rate emphasizes the importance of early detection.
Preventive Measures: Basic hygiene, antibiotics, and nutritional rehabilitation can significantly slow its spread.
Modern Challenge: Access to effective drugs and surgical treatment remains challenging for many due to extreme poverty.

Inclusion in WHO’s NTD List

Significance: Recognition aims to amplify global awareness, catalyze research, stimulate funding, and boost efforts to control the disease.
Call for Action: Médecins Sans Frontières / Doctors Without Borders emphasize the need for increased attention and resources to tackle noma.

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