1921
Volume 78, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Noma, or cancrum oris, is a debilitating necrotizing ulcerative stomatitis that destroys the mouth and face. It usually starts in early childhood and is associated with severe poverty, malnutrition, and infections. It is most frequently described from sub-Saharan Africa but is under-reported. There have been very few reports from Asia. We describe the clinical and social features of a series of 12 patients with noma from remote poor villages in rural Lao People’s Democratic Republic (Laos). Noma is an ominous stigma of severe poverty and the description of this disease emphasizes the importance of poverty reduction and nutritional improvement in Lao development. In the meantime, more awareness of the problem and the importance of early therapy in acute noma by primary health care workers may reduce mortality and prevent progression to severe disfigurement.

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References

  1. Barmes DE, Enwonwu CO, Leclercq MH, Bourgeois D, Falkler WA, 1997. The need for action against orofacial gangrene (noma). Trop Med Int Health 2 : 1111–1114. [Google Scholar]
  2. Enwonwu CO, Falkler WA, Phillips RS, 2006. Noma (cancrum oris). Lancet 368 : 147–156. [Google Scholar]
  3. Enwonwu CO, 2006. Noma—the ulcer of extreme poverty. N Engl J Med 354 : 221–224. [Google Scholar]
  4. Damme PA, 2006. Essay: noma. Lancet 368 (Suppl 1): S61–S62. [Google Scholar]
  5. Marck KW, 2003. A history of noma, the “face of poverty”. Plast Reconstr Surg 111 : 1702–1707. [Google Scholar]
  6. Marck KW, 2003. Noma: The Face of Poverty. Hannover: Verlag.
  7. Donald J, 1892. Noma as a complication of enteric fever. Lancet 1892 : 417. [Google Scholar]
  8. Baratti-Mayer D, Pittet B, Montandon D, Bolivar I, Bornand JE, Hugonnet S, Jaquinet A, Schrenzel J, Pittet D, Geneva Study Group on Noma, 2003. Noma: an “infectious” disease of unknown aetiology. Lancet Infect Dis 3 : 419–431. [Google Scholar]
  9. Enwonwu CO, Falkler WA Jr, Idigbe EO, Afolabi BM, Ibrahim M, Onwujekwe D, Savage O, Meeks VI, 1999. Pathogenesis of cancrum oris (noma): confounding interactions of malnutrition with infection. Am J Trop Med Hyg 60 : 223–232. [Google Scholar]
  10. World Health Organization, 2000. Management of the Child With Serious Infection or Severe Malnutrition. Geneva: WHO.
  11. World Health Organization, 1998. World Health Report. Geneva: WHO.
  12. Tuan PD, 1962. Noma in Viet-Nam. Indian J Pediatr 29 : 367–374. [Google Scholar]
  13. Fackler ML, 1971. Reconstruction surgery in Vietnam. US Navy Med 58 : 12–17. [Google Scholar]
  14. Black FO, 1973. Experiences of an otolaryngologist in Vietnam. South Med J 66 : 308–312. [Google Scholar]
  15. Reynaud J, 1950. Noma and penicillin therapy in Afghanistan. Rev Odontostomatol (Paris) 6 : 125–138. [Google Scholar]
  16. Mehrotra MC, 1966. Cancrum oris. A clinical survey of 20 cases. J Indian Med Assoc 47 : 555–557. [Google Scholar]
  17. Pindborg JJ, Bhat M, Devanath KR, Narayana HR, Ramachandra S, 1966. Occurrence of acute necrotizing gingivitis in South Indian children. J Periodontol 37 : 14–19. [Google Scholar]
  18. Pindborg JJ, Bhat M, Roed-Petersen B, 1967. Oral changes in South Indian children with severe protein deficiency. J Periodontol 38 : 218–221. [Google Scholar]
  19. Biswal N, Mahadevan S, Srinivasan S, 1992. Gangrenous stomatitis following measles. Indian Pediatr 29 : 509–511. [Google Scholar]
  20. Malden N, 1985. An interesting case of adult facial gangrene (from Papua, New Guinea). Oral Surg Oral Med Oral Pathol 59 : 279–281. [Google Scholar]
  21. Dooley T, 1960. The Night They Burned the Mountain. Kingswood, UK: The World’s Work.
  22. UNDP, 2005. Human Development Report. Available at: http://hdr.undp.org/reports/global/2005/pdf/HDR05_complete.pdf. Accessed March 21, 2007.
  23. Enwonwu CO, Phillips RS, Ferrell CD, 2005. Temporal relationship between the occurrence of fresh noma and the timing of linear growth retardation in Nigerian children. Trop Med Int Health 10 : 65–73. [Google Scholar]
  24. Phimmasone K, Douangpoutha I, Fauveau V, Pholsena P, 1996. Nutritional status of children in the Lao PDR. J Trop Pediatr 42 : 5–11. [Google Scholar]
  25. Ministry of Health, Government of Lao PDR, 2001. Health Status of the People in the Lao PDR. Report of the National Health Survey. Vientiane, Lao PDR: State Planning Committee.
  26. Miyoshi M, Phommasack B, Nakamura S, Kuroiwa C, 2005. Nutritional status of children in rural Lao PDR: who are the most vulnerable? Eur J Clin Nutr 59 : 887–890. [Google Scholar]
  27. Mayxay M, Khomthilat T, Souvannasing P, Phounesavath K, Vorasane B, Keomany S, Douangdala P, Philavong K, Srour L, Newton PN, 2007. Factors associated with a measles outbreak in children admitted at Mahosot Hospital, Vientiane, Laos. BMC Public Health 7 : 193. [Google Scholar]
  28. Kuroiwa C, Vongphrachanh P, Xayyavong P, Southalack K, Hashizume M, Nakamura S, 2001. Measles epidemiology and outbreak investigation using IgM test in Laos. J Epidemiol 11 : 255–262. [Google Scholar]
  29. Mayxay M, Nair S, Sudimack D, Imwong M, Tanomsing N, Pongvongsa T, Phompida S, Phetsouvanh R, White NJ, Newton PN, 2007. Combined molecular and clinical assessment of Plasmodium falciparum antimalarial drug resistance in the Lao P.D.R (Laos). Am J Trop Med Hyg 77 : 36–43. [Google Scholar]
  30. CLE, 2007. Weekly Epidemiological Surveillance Report. Lao PDR: Division of Epidemiology, National Centre for Laboratory and Epidemiology, Ministry of Health, Government of the Lao PDR.
  31. Phimphachanh C, Sayabounthavong K, 2004. The HIV/AIDS/STI situation in Lao People’s Democratic Republic. AIDS Educ Prev 16 (Suppl A): 91–99. [Google Scholar]
  32. Adelekan DA, 2003. Childhood nutrition and malnutrition in Nigeria. Nutrition 19 : 179–181. [Google Scholar]
  33. Barennes H, Simmala C, Odermatt P, Thaybouavone T, Vallee J, Martinez-Aussel B, Newton PN, Strobel M, 2007. Postpartum traditions and nutrition among urban Lao women and their infants in Vientiane, Lao PDR. Eur J Clin Nutr. Epub ahead of print November 14, 2007. [Google Scholar]
  34. Sisouphanthong B, Taillard C, 2000. Atlas of Laos. Chiang Mai, Thailand: NIAS/Silkworm Books.
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  • Received : 03 Dec 2007
  • Accepted : 05 Dec 2007

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