CURRENT AFFAIRS
CURRENT AFFAIRS
Description
Noma, also known as cancrum oris, is a severe, rapidly progressing gangrenous disease that primarily affects children between the ages of 2 and 6. The World Health Organization (WHO) officially classified it as a neglected tropical disease in December 2023. Although most commonly reported in sub-Saharan Africa, cases have also been documented in parts of Asia and the Americas. The disease is known for its devastating effects, often resulting in severe facial disfigurement and significant social stigma.
Causes And Risk Factors
Noma is associated with a combination of non-specific polymicrobial infections that thrive in conditions of extreme poverty. The primary risk factors for the disease include:
Malnutrition – A weakened immune system due to poor nutrition increases susceptibility.
Poor oral hygiene – Lack of proper dental care can contribute to the development of the disease.
Underlying infections – Conditions such as measles, malaria, and HIV can increase vulnerability.
Severe poverty – Overcrowding, lack of clean water, and limited access to healthcare exacerbate the risk.
Weaning period – Many cases arise when children transition from breastfeeding to solid foods, a period often marked by nutritional deficiencies.
Progression And Stages Of Noma
Noma progresses rapidly through distinct clinical stages if left untreated. According to WHO, the disease follows five stages:
Stage 0 – Simple gingivitis (gum inflammation)
Stage 1 – Acute necrotising gingivitis
Stage 2 – Facial swelling and oedema
Stage 3 – Gangrene, causing severe tissue destruction
Stage 4 – Scarring and deformities
Stage 5 – Long-term complications and disabilities
The disease often begins as mild gingivitis but can escalate within days, leading to extensive facial tissue destruction and, in many cases, death.
Treatment And Management
Early intervention is essential to improve survival rates. At the acute necrotising gingivitis stage, treatment typically includes:
Enhanced oral hygiene – Regular mouth cleaning and improved dental care.
Antibiotic therapy – Targeted antibiotics to combat bacterial infection.
Nutritional support – Supplementing essential vitamins and minerals to strengthen immunity.
Despite early intervention, noma has an extremely high fatality rate, with only 15% of affected children surviving without treatment. Those who survive often suffer from severe facial disfigurements, requiring reconstructive surgery and long-term rehabilitation to restore function and improve quality of life.
Challenges In Global Response
Estimating the true prevalence of noma is difficult due to limited surveillance systems, high fatality rates, and social stigma surrounding the disease. WHO’s last global estimate from 1998 suggested around 140,000 cases annually, though the actual number may be much higher.
To address the issue, WHO has launched several initiatives aimed at:
Raising awareness about noma among healthcare workers and affected communities.
Strengthening disease surveillance to improve reporting and intervention.
Integrating noma control into broader healthcare programs for malnutrition and infectious diseases.
In 2012, the UN Human Rights Council acknowledged the neglect of noma as a potential violation of children’s rights, urging global action to combat the disease.
The Way Forward
The WHO’s strategy for tackling noma includes:
Strengthening healthcare systems to provide better diagnosis and treatment.
Training medical professionals to identify early-stage noma and intervene promptly.
Increasing community awareness to reduce stigma and encourage early medical intervention.
Improving food security and vaccination programs to prevent underlying health conditions that contribute to noma.
Despite being preventable and treatable, noma continues to be a significant public health concern in impoverished regions. Addressing this neglected disease requires sustained advocacy, increased funding, and global cooperation to ensure early detection, treatment, and long-term support for affected individuals.
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