ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Ashok N, Tarakji B, Darwish S, Rodrigues JC, Altamimi MA, 2016. A review on noma: A recent update. Glob J Health Sci 8: 53.
-
2.
Paster BJ, Falkler WA Jr., Enwonwu CO, Idigbe EO, Savage KO, Levanos VA, Tamer MA, Ericson RL, Lau CN, Dewhirst FE, 2002. Prevalent bacterial species and novel phylotypes in advanced noma lesions. J Clin Microbiol 40: 2187–2191.
-
3.
Enwonwu CO, 1995. Noma: A neglected scourge of children in sub-Saharan Africa. Bull World Health Organ 73: 541.
-
4.
Giddon DB, Jerome Zackin S, Goldhaber P, 1964. Acute necrotizing ulcerative gingivitis in college students. J Am Dent Assoc 68: 381–386.
-
5.
Marck KW, 2003. A history of noma, the “Face of Poverty”. Plast Reconstr Surg 111: 1702–1707.
-
6.
Falkler WA, 1999. Microbiological understandings and mysteries of noma (cancrum oris). Oral Dis 5: 508–519.
-
7.
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.
-
8.
Enwonwu CO, 1972. Epidemiological and biochemical studies of necrotizing ulcerative gingivitis and noma (cancrum oris) in Nigerian children. Arch Oral Biol 17: 1357–1371.
-
9.
Bolivar I, Whiteson K, Stadelmann B, Baratti-Mayer D, Gizard Y, Mombelli A, Pittet D, Schrenzel J; Geneva Study Group on Noma (GESNOMA), 2012. Bacterial diversity in oral samples of children in Niger with acute noma, acute necrotizing gingivitis, and healthy controls. PLoS Negl Trop Dis 6: e1556.
-
10.
Farley E, Mehta U, Srour ML, Lenglet A, 2021. Noma (cancrum oris): A scoping literature review of a neglected disease (1843–2021). PLoS Negl Trop Dis 15: e0009844.
-
11.
Farley E, Lenglet A, Ariti C, Jiya NM, Adetunji AS, van der Kam S, Bil K, 2018. Risk factors for diagnosed noma in northwest Nigeria: A case-control study, 2017. PLoS Negl Trop Dis 12: e0006631.
-
12.
Tonna JE, Lewin MR, Mensh B, 2010. A case and review of noma. PLoS Negl Trop Dis 4: e869.
-
13.
Baratti-Mayer D, et al., 2013. Risk factors for noma disease: A 6-year, prospective, matched case-control study in Niger. Lancet Glob Health 1: e87–e96.
-
14.
Braimah RO, Adeniyi AS, Taiwo AO, Ibikunle AA, Gbotolorun MO, Aregbesola SB, Abdulazeez K, Bala M, 2017. Risk factors and mortality rate of acute cancrum oris (noma) in Sokoto North-West Nigeria: A 13-year survey. J Paediatr Dent 5: 1–5.
-
15.
Whiteson KL, Lazarevic V, Tangomo-Bento M, Girard M, Maughan H, Pittet D, Francois P, Schrenzel J, 2014. Noma affected children from Niger have distinct oral microbial communities based on high-throughput sequencing of 16S rRNA gene fragments. PLoS Negl Trop Dis 8: e3240.
-
16.
D’Agostino FJ, 1951. A review of noma: Report of a case treated with aureomycin. Oral Surg Oral Med Oral Pathol 4: 1000–1006.
-
17.
Koech KJ, 2010. Cancrum oris in an adult with human immunodeficiency virus infection: Case report. East Afr Med J 87: 38–40.
-
18.
Lembo S, Leonibus CD, Francia MG, Lembo C, Ayala F, 2011. Cancrum oris in a boy with Down syndrome. J Am Acad Dermatol 64: 1200–1202.
-
19.
van Niekerk C, Khammissa RAG, Altini M, Lemmer J, Feller L, 2014. Noma and cervicofacial necrotizing fasciitis: Clinicopathological differentiation and an illustrative case report of noma. AIDS Res Hum Retroviruses 30: 213–216.
-
20.
Vaidyanathan S, Tullu MS, Lahiri KR, Deshmukh CT, 2005. Pseudomonas sepsis with noma: An association? Indian J Med Sci 59: 357–360.
-
21.
Hartman EHM, Damme PAV, Rayatt S, Kuokkanen HOM, 2010. Return of the Waltzing flap in noma reconstructive surgery: Revisiting the past in difficult circumstances. J Plast Reconstr Aesthet Surg 63: e80–e81.
-
22.
Enwonwu CO, 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.
-
23.
Srour ML, Watt B, Phengdy B, Khansoulivong K, Harris J, Bennett C, Strobel M, Dupuis C, Newton PN, 2008. Noma in Laos: Stigma of severe poverty in rural Asia. Am J Trop Med Hyg 78: 539–542.
-
24.
Marck KW, 2013. Noma: A neglected enigma. Lancet Glob Health 1: e58–e59.
-
25.
Berthold P, 2003. Noma: A forgotten disease. Dent Clin 47: 559–574.
-
26.
Farley E, et al., 2021. Noma, a neglected disease: A viewpoint article. PLoS Negl Trop Dis 15: e0009437.
-
27.
Maley A, Desai M, Parker S, 2015. Noma: A disease of poverty presenting at an urban hospital in the United States. JAAD Case Rep 1: 18–20.
-
28.
Ogbureke KU, Ogbureke EI, 2010. Noma: A preventable “scourge” of African children. Open Dent J 4: 201.
-
29.
Hotez PJ, 2021. Forgotten People, Forgotten Diseases: The Neglected Tropical Diseases and Their Impact on Global Health and Development. Hoboken, NJ: John Wiley & Sons.
-
30.
Speiser S, Langridge B, Birkl MM, Kubiena H, Rodgers W, 2021. Update on noma: Systematic review on classification, outcomes and follow-up of patients undergoing reconstructive surgery after noma disease. BMJ Open 11: e046303.
-
31.
Brady-West DC, Richards L, Thame J, Moosdeen F, Nicholson A, 1998. Cancrum oris (noma) in a patient with acute lymphoblastic leukaemia. A complication of chemotherapy induced neutropenia. West Indian Med J 47: 33–34.
-
32.
Srour ML, Baratti-Mayer D, 2020. Why is noma a neglected-neglected tropical disease? PLoS Negl Trop Dis 14: e0008435.
-
33.
Dominic C, Farley E, Elkheir N, 2022. More than 100 years of neglect: A bibliometric analysis of global research on noma (cancrum oris). Trans R Soc Trop Med Hyg 116: 479–486.
-
34.
Gebretsadik HG, 2023. An update on the risk factors of noma (facial gangrene) in Ethiopia. Fortune J Health Sci 6: 103–108.
-
35.
Srour ML, Marck K, Baratti-Mayer D, 2017. Noma: Overview of a neglected disease and human rights violation. Am J Trop Med Hyg 96: 268–274.
-
36.
Weledji EP, Njong S, 2016. Cancrum oris (noma): The role of nutrition in management. J Am Coll Clin Wound Spec 7: 50–52.
-
37.
Sophie H, Thomas F, Jürg U, 2013. Noma: Epidemiology and Global Burden of a Neglected Disease. ISEE Conference Abstracts. Available at: https://ehp.niehs.nih.gov/doi/abs/10.1289/isee.2013.P-1-14-13. Accessed September 19, 2013.
-
38.
Yuca K, Yuca SA, Cankaya H, Caksen H, Calka O, Kiriş M, 2004. Report of an infant with noma (cancrum oris). J Dermatol 31: 488–491.
-
39.
Pedro K, Smit DA, Morkel JA, 2016. Cancrum oris (noma) in an HIV-positive adult: A case report and literature review. S Afr Dent J 71: 248–252.
-
40.
Costini B, Larroque G, Duboscq JC, Montandon D, 1995. Noma or cancrum oris: Etiopathogenic and nosologic aspects. Med Trop (Mars) 55: 263–273.
-
41.
Jain A, Ranka R, 2017. The real face of “face of poverty”: An insight on noma. Hosp Palliat Med Int J 1: 49–52.
-
42.
Baratti-Mayer D, Pittet B, Montandon D, Bolivar I, Bornand JE, Hugonnet S, Jaquinet A, Schrenzel J, Pittet D, 2003. Noma: An “infectious” disease of unknown aetiology. Lancet Infect Dis 3: 419–431.
-
43.
Rickart AJ, Rodgers W, Mizen K, Merrick G, Wilson P, Nishikawa H, Dunaway DJ, 2020. Facing Africa: Describing noma in Ethiopia. Am J Trop Med Hyg 103: 613.
-
44.
Issa AH, Ousmane KAK, Issa EOH, Shen J, Douma MD, Ibrahim AS, Rachel IK, Guan Y, 2021. Influencing Factors for Social Acceptance of Noma (Cancrum Oris) Patients in Niger: A Hospital based Retrospective Study. Available at: https://papers.ssrn.com/abstract=3878080. Accessed March 24, 2022.
-
45.
Adeniyi SA, Awosan KJ, 2019. Pattern of noma (cancrum oris) and its risk factors in northwestern Nigeria: A hospital-based retrospective study. Ann Afr Med 18: 17–22.
-
46.
Galli A, Brugger C, Fürst T, Monnier N, Winkler MS, Steinmann P, 2022. Prevalence, incidence, and reported global distribution of noma: A systematic literature review. Lancet Infect Dis 22: e221–e230.
-
47.
World Health Organization, 2024. Opinion: It’s Official, Noma Is a Neglected Tropical Disease. Now What? Available at: https://www.who.int/news/item/18-01-2024-opinion-it-Is-official-noma-is-a-neglected-tropical-disease-now-what. Accessed July 9, 2024.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 709 | 709 | 63 |
| Full Text Views | 39 | 39 | 6 |
| PDF Downloads | 46 | 46 | 7 |
Nonparametric Testing of Body Mass Index as a Predictor of Severe Noma: Assessing Potential Association
Heron G. Gebretsadik
gebretsadik@euclidfaculty.net
Heron G. Gebretsadik
School of Global Health and Bioethics, Euclid University, Banjul, The Gambia
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ABSTRACT.
Noma, a devastating facial disease, primarily affects impoverished populations in low- and middle-income countries, often leading to severe disfigurement or fatality if untreated. Studies suggest malnutrition is a significant risk factor for noma, yet the association between body mass index (BMI) in kilograms per square meter and tissue damage severity remains underexplored. This study aimed to investigate the relationship between BMI and tissue damage severity among noma cases in Ethiopia. A retrospective analysis of medical records from Facing Africa’s database covering noma cases treated between 2007 and 2019 was conducted. A standardized data collection template recorded demographic and clinical data, including patient demographics, BMI, and tissue damage severity levels. JASP statistical software was used for analysis. Analysis of 228 noma cases revealed a mean BMI of 17.8 kg/m2, ranging from 11.5 to 28.3 kg/m2. Females exhibited a higher mean BMI (18.3 kg/m2) than males (16.9 kg/m2). Differences in BMI distributions between major (67) and minor (30) tissue damage categories were observed, with “minor” cases having a slightly higher mean BMI. The study found a statistically significant association between BMI and tissue damage severity (P = 0.03), indicating that tissue damage due to noma worsened as BMI decreased. Nonparametric tests confirmed this association’s significance. This study highlights low BMI as a predictor of severe noma. Public health interventions should focus on malnutrition to reduce noma severity and psychosocial and functional morbidity and improve outcomes. However, additional factors influencing the progression of noma and the severity of associated tissue damage require further investigation.
Author Notes
Disclosures: Ethical clearance was granted by the Addis Ababa Health Bureau Institutional Review Board (IRB) Ethics Committee. The approval number for the clearance declaration is A/A/H/B/2116/227. The confidentiality of the medical information of the patients was maintained. Furthermore, the researcher used the patients’ initials in the medical case report form (MCRFs) and Excel spreadsheet. All cases of noma included in the analysis had provided written consent for the use of their medical information and photographs for research and publication purposes. For minors, consent was obtained from their parents or legal guardians for the use of their photographs for these purposes.
Current contact information: Heron G. Gebretsadik, School of Global Health and Bioethics, Euclid University, Banjul, The Gambia, E-mails: gebretsadik@euclidfaculty.net or gezahegn.heron@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Ashok N, Tarakji B, Darwish S, Rodrigues JC, Altamimi MA, 2016. A review on noma: A recent update. Glob J Health Sci 8: 53.
-
2.
Paster BJ, Falkler WA Jr., Enwonwu CO, Idigbe EO, Savage KO, Levanos VA, Tamer MA, Ericson RL, Lau CN, Dewhirst FE, 2002. Prevalent bacterial species and novel phylotypes in advanced noma lesions. J Clin Microbiol 40: 2187–2191.
-
3.
Enwonwu CO, 1995. Noma: A neglected scourge of children in sub-Saharan Africa. Bull World Health Organ 73: 541.
-
4.
Giddon DB, Jerome Zackin S, Goldhaber P, 1964. Acute necrotizing ulcerative gingivitis in college students. J Am Dent Assoc 68: 381–386.
-
5.
Marck KW, 2003. A history of noma, the “Face of Poverty”. Plast Reconstr Surg 111: 1702–1707.
-
6.
Falkler WA, 1999. Microbiological understandings and mysteries of noma (cancrum oris). Oral Dis 5: 508–519.
-
7.
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.
-
8.
Enwonwu CO, 1972. Epidemiological and biochemical studies of necrotizing ulcerative gingivitis and noma (cancrum oris) in Nigerian children. Arch Oral Biol 17: 1357–1371.
-
9.
Bolivar I, Whiteson K, Stadelmann B, Baratti-Mayer D, Gizard Y, Mombelli A, Pittet D, Schrenzel J; Geneva Study Group on Noma (GESNOMA), 2012. Bacterial diversity in oral samples of children in Niger with acute noma, acute necrotizing gingivitis, and healthy controls. PLoS Negl Trop Dis 6: e1556.
-
10.
Farley E, Mehta U, Srour ML, Lenglet A, 2021. Noma (cancrum oris): A scoping literature review of a neglected disease (1843–2021). PLoS Negl Trop Dis 15: e0009844.
-
11.
Farley E, Lenglet A, Ariti C, Jiya NM, Adetunji AS, van der Kam S, Bil K, 2018. Risk factors for diagnosed noma in northwest Nigeria: A case-control study, 2017. PLoS Negl Trop Dis 12: e0006631.
-
12.
Tonna JE, Lewin MR, Mensh B, 2010. A case and review of noma. PLoS Negl Trop Dis 4: e869.
-
13.
Baratti-Mayer D, et al., 2013. Risk factors for noma disease: A 6-year, prospective, matched case-control study in Niger. Lancet Glob Health 1: e87–e96.
-
14.
Braimah RO, Adeniyi AS, Taiwo AO, Ibikunle AA, Gbotolorun MO, Aregbesola SB, Abdulazeez K, Bala M, 2017. Risk factors and mortality rate of acute cancrum oris (noma) in Sokoto North-West Nigeria: A 13-year survey. J Paediatr Dent 5: 1–5.
-
15.
Whiteson KL, Lazarevic V, Tangomo-Bento M, Girard M, Maughan H, Pittet D, Francois P, Schrenzel J, 2014. Noma affected children from Niger have distinct oral microbial communities based on high-throughput sequencing of 16S rRNA gene fragments. PLoS Negl Trop Dis 8: e3240.
-
16.
D’Agostino FJ, 1951. A review of noma: Report of a case treated with aureomycin. Oral Surg Oral Med Oral Pathol 4: 1000–1006.
-
17.
Koech KJ, 2010. Cancrum oris in an adult with human immunodeficiency virus infection: Case report. East Afr Med J 87: 38–40.
-
18.
Lembo S, Leonibus CD, Francia MG, Lembo C, Ayala F, 2011. Cancrum oris in a boy with Down syndrome. J Am Acad Dermatol 64: 1200–1202.
-
19.
van Niekerk C, Khammissa RAG, Altini M, Lemmer J, Feller L, 2014. Noma and cervicofacial necrotizing fasciitis: Clinicopathological differentiation and an illustrative case report of noma. AIDS Res Hum Retroviruses 30: 213–216.
-
20.
Vaidyanathan S, Tullu MS, Lahiri KR, Deshmukh CT, 2005. Pseudomonas sepsis with noma: An association? Indian J Med Sci 59: 357–360.
-
21.
Hartman EHM, Damme PAV, Rayatt S, Kuokkanen HOM, 2010. Return of the Waltzing flap in noma reconstructive surgery: Revisiting the past in difficult circumstances. J Plast Reconstr Aesthet Surg 63: e80–e81.
-
22.
Enwonwu CO, 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.
-
23.
Srour ML, Watt B, Phengdy B, Khansoulivong K, Harris J, Bennett C, Strobel M, Dupuis C, Newton PN, 2008. Noma in Laos: Stigma of severe poverty in rural Asia. Am J Trop Med Hyg 78: 539–542.
-
24.
Marck KW, 2013. Noma: A neglected enigma. Lancet Glob Health 1: e58–e59.
-
25.
Berthold P, 2003. Noma: A forgotten disease. Dent Clin 47: 559–574.
-
26.
Farley E, et al., 2021. Noma, a neglected disease: A viewpoint article. PLoS Negl Trop Dis 15: e0009437.
-
27.
Maley A, Desai M, Parker S, 2015. Noma: A disease of poverty presenting at an urban hospital in the United States. JAAD Case Rep 1: 18–20.
-
28.
Ogbureke KU, Ogbureke EI, 2010. Noma: A preventable “scourge” of African children. Open Dent J 4: 201.
-
29.
Hotez PJ, 2021. Forgotten People, Forgotten Diseases: The Neglected Tropical Diseases and Their Impact on Global Health and Development. Hoboken, NJ: John Wiley & Sons.
-
30.
Speiser S, Langridge B, Birkl MM, Kubiena H, Rodgers W, 2021. Update on noma: Systematic review on classification, outcomes and follow-up of patients undergoing reconstructive surgery after noma disease. BMJ Open 11: e046303.
-
31.
Brady-West DC, Richards L, Thame J, Moosdeen F, Nicholson A, 1998. Cancrum oris (noma) in a patient with acute lymphoblastic leukaemia. A complication of chemotherapy induced neutropenia. West Indian Med J 47: 33–34.
-
32.
Srour ML, Baratti-Mayer D, 2020. Why is noma a neglected-neglected tropical disease? PLoS Negl Trop Dis 14: e0008435.
-
33.
Dominic C, Farley E, Elkheir N, 2022. More than 100 years of neglect: A bibliometric analysis of global research on noma (cancrum oris). Trans R Soc Trop Med Hyg 116: 479–486.
-
34.
Gebretsadik HG, 2023. An update on the risk factors of noma (facial gangrene) in Ethiopia. Fortune J Health Sci 6: 103–108.
-
35.
Srour ML, Marck K, Baratti-Mayer D, 2017. Noma: Overview of a neglected disease and human rights violation. Am J Trop Med Hyg 96: 268–274.
-
36.
Weledji EP, Njong S, 2016. Cancrum oris (noma): The role of nutrition in management. J Am Coll Clin Wound Spec 7: 50–52.
-
37.
Sophie H, Thomas F, Jürg U, 2013. Noma: Epidemiology and Global Burden of a Neglected Disease. ISEE Conference Abstracts. Available at: https://ehp.niehs.nih.gov/doi/abs/10.1289/isee.2013.P-1-14-13. Accessed September 19, 2013.
-
38.
Yuca K, Yuca SA, Cankaya H, Caksen H, Calka O, Kiriş M, 2004. Report of an infant with noma (cancrum oris). J Dermatol 31: 488–491.
-
39.
Pedro K, Smit DA, Morkel JA, 2016. Cancrum oris (noma) in an HIV-positive adult: A case report and literature review. S Afr Dent J 71: 248–252.
-
40.
Costini B, Larroque G, Duboscq JC, Montandon D, 1995. Noma or cancrum oris: Etiopathogenic and nosologic aspects. Med Trop (Mars) 55: 263–273.
-
41.
Jain A, Ranka R, 2017. The real face of “face of poverty”: An insight on noma. Hosp Palliat Med Int J 1: 49–52.
-
42.
Baratti-Mayer D, Pittet B, Montandon D, Bolivar I, Bornand JE, Hugonnet S, Jaquinet A, Schrenzel J, Pittet D, 2003. Noma: An “infectious” disease of unknown aetiology. Lancet Infect Dis 3: 419–431.
-
43.
Rickart AJ, Rodgers W, Mizen K, Merrick G, Wilson P, Nishikawa H, Dunaway DJ, 2020. Facing Africa: Describing noma in Ethiopia. Am J Trop Med Hyg 103: 613.
-
44.
Issa AH, Ousmane KAK, Issa EOH, Shen J, Douma MD, Ibrahim AS, Rachel IK, Guan Y, 2021. Influencing Factors for Social Acceptance of Noma (Cancrum Oris) Patients in Niger: A Hospital based Retrospective Study. Available at: https://papers.ssrn.com/abstract=3878080. Accessed March 24, 2022.
-
45.
Adeniyi SA, Awosan KJ, 2019. Pattern of noma (cancrum oris) and its risk factors in northwestern Nigeria: A hospital-based retrospective study. Ann Afr Med 18: 17–22.
-
46.
Galli A, Brugger C, Fürst T, Monnier N, Winkler MS, Steinmann P, 2022. Prevalence, incidence, and reported global distribution of noma: A systematic literature review. Lancet Infect Dis 22: e221–e230.
-
47.
World Health Organization, 2024. Opinion: It’s Official, Noma Is a Neglected Tropical Disease. Now What? Available at: https://www.who.int/news/item/18-01-2024-opinion-it-Is-official-noma-is-a-neglected-tropical-disease-now-what. Accessed July 9, 2024.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 709 | 709 | 63 |
| Full Text Views | 39 | 39 | 6 |
| PDF Downloads | 46 | 46 | 7 |