Abstract
BackgroundNoma is a spreading and fulminant disease believed to be native to Sub-Saharan Africa over the last decade and associated with low socioeconomic status of citizens of the region. Within this noma belt, most epidemiological reports regarding the disease have emanated from the north western region of Nigeria. However, our indigenous surgical mission encountered a substantial number of cases of noma and post-noma defects noteworthy of epidemiological representation across north central Nigeria.MethodsAll noma cases encountered within the 8-year study period were included and divided based on clinical signs into acute and sequelae groups. Incidence estimation was based on acute/recently active cases and was calculated using the statistical method proposed by the WHO Oral Health Unit (1994). Period prevalence of noma was calculated considering the population at risk in the zone.FindingsA total of 78 subjects were included in the study with age ranging from 2–75 years. Twelve subjects (15.4%) presented with acute disease while 66 (84.6%) had various forms of post-noma defects. The estimated incidence of noma in the north central zone was 8.3 per 100000 with a range of 4.1–17.9 per 100000 across various states. Period prevalence of noma which incorporated all cases seen within the study period was 1.6 per 100000 population at risk.ConclusionAlthough noma may be more prevalent in the north western region of Nigeria, substantial number of cases occurs within the north central zone which calls for deliberate public awareness campaign on disease risk factors and prevention, and education of primary health-care providers.
Highlights
Noma is a disease of the orofacial region that has been unanimously described as devastating, mutilating, destructive and debilitating due to its appearance and the nature of spread of the acute necrotizing lesion which runs fulminating courses
As epidemiological data is important for planning and prioritisation of service delivery as well as formulation of disease preventive strategies, we aim to provide an epidemiological report on noma disease in north central Nigeria by determining the incidence, prevalence, trend and risk factors for noma in the sub-region based on the health data records of noma cases encountered by our foundation over an eight years period spanning from 2010 to 2018
Our volunteer-based surgical mission discovered a substantial number of noma cases noteworthy of epidemiologic representation in north central Nigeria, which would allow for adequate characterization of the disease burden in this region– an area resident to the third-highest number of citizens living below poverty line in Nigeria [12]
Summary
Noma is a disease of the orofacial region that has been unanimously described as devastating, mutilating, destructive and debilitating due to its appearance and the nature of spread of the acute necrotizing lesion which runs fulminating courses. Despite being a disease first described over four centuries ago as affecting several world regions, noma is currently regarded as being exclusive to the tropics (notably sub-Saharan Africa) [6,7], which is accredited to the preponderance of noma predisposing factors in the region These factors include socioeconomic factors such as low standards of living, extreme poverty, poor sanitary conditions and close proximity of residence to livestock. Noma is a spreading and fulminant disease believed to be native to Sub-Saharan Africa over the last decade and associated with low socioeconomic status of citizens of the region Within this noma belt, most epidemiological reports regarding the disease have emanated from the north western region of Nigeria.
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