Noma (CANCRUM ORIS): Causes, Treatment and Signs and Symptoms

noma is a rapid, grossly mutilating gangrenous stomatitis of the oro-facial tissues, which occur in young children aged 2-6 years, mainly in the under developed countries

Noma cancrum oris (documenting reality)

What is noma cancrum oris?

noma is a rapid, grossly mutilating gangrenous stomatitis of the oro-facial tissues, which occur in young children aged 2-6 years, mainly in the underdeveloped countries in Africa and East Asia and part of America, but particularly in West Africa, with Nigeria, Senegal and Burkina Faso having the highest incidence.

Main Keywords: Cancrum Oris, Soma, Acute Gangrenous Stomatitis, Acute Necrotising Gingivitis

Cancrum Oris Flip Book

 

Causes of noma cancrum oris?

Noma is a multifactorial disease, usually associated with local and systemic factors.

Source: Internet achieved books

1. Gross malnutrition.
2. Protein-energy malnutrition (PEM)
3. Acute ulcerative gingivitis (ANUG).
4. Immunodeficiency disease such as Aids.
5. Measles.
6. Smoking and many another bad oral habit.

Malnutrition is a prime predisposing systemic factor, with poor oral hygiene and Acute ulcerative gingivitis being the significant local factors.

  Noma is a deadly disease, found almost exclusively in grossly malnutrition children in the poorest countries of the world. The advanced stage of noma is predominantly necrotic with rapid sequestration of the underlying exposed bone and loss of teeth. If not treated early and effectively, the child soon dies.

Treatment of noma Cancrum Oris

 Mortality due to noma cancrum oris can be reduced with prompt, appropriate treatment. Noma is one of the most devastating human diseases worldwide and has been designated a health priority by the WHO.

• Prevention is the treatment of choice. 
• Once Noma is established, no other form of treatment is really satisfactory.
•  The progression of the disease can be treated with the use of antibiotics such as penicillin, tetracycline, metronidazole and clindamycin and improved nutrition.
• And it may require oral and maxillofacial surgery to repair.
• There may be delayed in full recovery it usually takes several months.

WHO has set up a five-point STRATEGY, against NOMA

World Health Organization in Africa fight against NOMA

Noma-disease-affecting-young-child (documenting reality)

  1. Prevention - involving information and education to make parents especially mothers, and health workers aware of the early sign of NOMA and the need for urgent treatment.

 2. Epidemiology and surveillance.

 3. Promoting research.

 4. Primary care.

 5. Surgery and rehabilitation.

Noma Cancrum Oris Video

MEDICAL REFERENCES

These references are in PubMed. This may not be the complete list of references from this article. See also: Uptodate.com/contents/noma-cancrum-oris

1. Devi SR, Gogoi M. Aesthetic restoration of facial defect caused by cancrum oris: A case report. Indian J Plast Surg. 2003;36:131–133.
2. Adams-Ray WE, James JH. Cancrum oris: functional and cosmetic reconstruction in patients with ankylosis of the jaws. Br J Plast Surg. 1992;45(3):193–8. doi: 10.1016/0007-1226(92)90075-9 [PubMed][Cross Ref]
3.  Oluwasanmi JO, Lagundoye SB, Akinyemi OO. Ankylosis of the mandible from cancrum oris. Plast Reconstr Surg. 1976;57(3):342–50. doi: 10.1097/00006534-197603000-00011. [PubMed] [Cross Ref]
4.  Enwonwu CO, Falkler WA, Idigbe EO. Oro-facial gangrene (noma/ cancrum oris): pathogenetic mechanisms. Crit Rev Oral Biol Med. 2000;11(2):159–71. doi: 10.1177/10454411000110020201.[PubMed] [Cross Ref]
5. Smith I. Vincent angina and fusiform bacillus; Cancrum Oris. J Maxillofacial Surg. 1970;7:293–8. doi: 10.1016/S0301-0503(79)80054-5. [Cross Ref]
6.  Folayan MO. The epidemiology, etiology, pathophysiology of acute necrotising ulcerative gingivitis associated with malnutrition. J Contemp Dent Pract. 2004;5(3):028–31.
7.  Falkler WA, Enwonwu CO, Idigbe EO. Isolation of Fusobacterium necrophorum from cancrum oris (noma) Am J Trop Med Hyg. 1999;60(1):150–156. [PubMed]
8.  Enwonwu CO, Falkler WA, Idigbe EO, Afolabi BM, Ibrahim M, Onwujekwe D, Savage O, Meeks VI. Pathogenesis of cancrum oris (noma): Confounding interactions of malnutrition with infection. Am J Trop Med Hyg. 1999;60(2):223–232. [PubMed]
9.  Dean JA, Magee W. One-stage reconstruction of defects caused by cancrum oris (noma) Ann Plast Surg. 1997;38:29–35. doi: 10.1097/00000637-199701000-00006. [PubMed] [Cross Ref]