Abstract
History and Epidemiology Historically, noma is a disease of extreme poverty and malnourishment, reported throughout history in Asia, Europe, South America, and Africa [1,3,4]. It was described by Hippocrates [5] and found in German and Japanese concentration camps during World War II [1,6]. Infection occurs mostly in children, although it has been described in neonates, adults, and the chronically ill [3,7]. The true prevalence and incidence of noma are not fully known, because it is believed that only ,15% of patients with acute cases of the disease seek medical care [1,8]. Noma is a disease of shame, and the condition often results in forced isolation from the community and family; many children are sent to live in isolation rather than being taken to medical care [1,8–10]. In the late 1990s, the incidence of acute childhood noma was placed at 25,600 in countries bordering the Sahara [11], and worldwide at between 100,000 and 140,000 per year, primarily in sub-Saharan Africa and Asia [12]. Peak incidence is among children aged 1–4 [3,4,7]. Worldwide prevalence of those living with the sequelae of noma was placed at 770,000 in 1997 [8].
Highlights
Noma is a disease of shame, and the condition often results in forced isolation from the community and family; many children are sent to live in isolation rather than being taken to medical care [1,8,9,10]
In the late 1990s, the incidence of acute childhood noma was placed at 25,600 in countries bordering the Sahara [11], and worldwide at Pathogenesis Infection is multifactorial in nature and not clearly understood
Treatment with antibiotics and nutrition increases survival of acute childhood noma to greater than 90% [3]
Summary
A young adult male villager in Madagascar developed painful, perioral swelling over a period of weeks.
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