Authors:
, , , , , , , , , , , , , , , , , and
ProCite
RefWorks
Reference Manager
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-
1.
Shaye DA, Winters R, Rabbels J, Adentunji AS, Magee A, Vo D, 2019. Noma surgery. Laryngoscope 129: 96–99.
-
2.
Prado-Calleros HM, Castillo-Ventura BB, Jiménez-Escobar I, Ramírez-Hinojosa JP, López-Gómez A, García-de-la-Cruz M, Dayan-Nurko M, 2018. Noma and noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review. J Infect Dev Ctries 12: 89–96.
-
3.
Gebretsadik HG, 2023. Shattered Smiles: The FACES of NOMA. Berlin, Germany: LAP LAMBERT Academic Publishing.
-
4.
Dufty J, Gkranias N, Donos N, 2017. Necrotising ulcerative gingivitis: A literature review. Oral Health Prev Dent 15: 321–327.
-
5.
Nash ES, Cheng LHH, Smart K, 1991. Cancrum oris-like lesions. Br J Oral Maxillofac Surg 29: 51–53.
-
6.
Enwonwu CO, Falkler WA Jr, Idigbe EO, 2000. Oro-facial gangrene (noma/cancrum oris): Pathogenetic mechanisms. Crit Rev Oral Biol Med 11: 159–171.
-
7.
Gollapudi M, Mohod S, Pankey N, Gatlewar P, 2024. Acute necrotizing ulcerative gingivitis: A case report. Cureus 16: e63023.
-
8.
Ashok N, Tarakji B, Darwish S, Rodrigues JC, Altamimi MA, 2015. A review on noma: A recent update. Glob J Health Sci 8: 53–59.
-
9.
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.
-
10.
Faye O, Keita M, N’diaye HT, Konare HD, Darie H, Keita S, Mahe A, 2003. Noma chez des adultes infectés par le VIH [Noma in HIV-infected adults]. Ann Dermatol Venereol 130: 199–201.
-
11.
Srour ML, Farley E, Mpinga EK, 2022. Lao noma survivors: A case series, 2002–2020. Am J Trop Med Hyg 106: 1269–1274.
-
12.
Miller LE, Shaye DA, 2021. Noma and necrotizing fasciitis of the face and neck. Facial Plast Surg 37: 439–445.
-
13.
Srour ML, Baratti-Mayer D, 2020. Why is noma a neglected-neglected tropical disease? PLoS Negl Trop Dis 14: e0008435.
-
14.
Bourgeois DM, Leclercq MH, 1999. The World Health Organization initiative on noma. Oral Dis 5: 172–174.
-
15.
World Health Organization, 2016. NOMA Is a Severe Disease It is Treatable If Detected and Managed Early! Available at: https://www.afro.who.int/sites/default/files/2017-07/Information_brochure_EN.pdf. Accessed April 26, 2024.
-
16.
Maley A, Desai M, Parker S, 2014. Noma: A disease of poverty presenting at an urban hospital in the United States. JAAD Case Rep 1: 18–20.
-
17.
Farley E et al., 2021. Noma, a neglected disease: A viewpoint article. PLoS Negl Trop Dis 15: e0009437.
-
18.
Caulfield A, Alfvén T, 2020. Improving prevention, recognition and treatment of noma. Bull World Health Organ 98: 365–366.
-
19.
Gupta A, Sardana K, Gautam RK, 2018. An unusual case of noma caused by Klebsiella pnuemoniae and its management. Trop Doct 48: 230–232.
-
20.
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.
-
21.
Madabhavi I, Revannasiddaiah S, Sarkar M, 2018. Cancrum oris (noma): An early sign of acute lymphoblastic leukemia relapse. Indian J Dermatol Venereol Leprol 84: 373.
-
22.
Srour ML, Marck KW, Baratti-Mayer D, 2015. Noma: Neglected, forgotten and a human rights issue. Int Health 7: 149–150.
-
23.
Khammissa RAG, Lemmer J, Feller L, 2022. Noma staging: A review. Trop Med Health 50: 40.
-
24.
Bourgeois DM, Diallo B, Frieh C, Leclercq MH, 1999. Epidemiology of the incidence of oro-facial noma: A study of cases in Dakar, Senegal, 1981–1993. Am J Trop Med Hyg 61: 909–913.
-
25.
Falkler WA Jr, Enwonwu CO, Idigbe EO, 1999. Microbiological understandings and mysteries of noma (cancrum oris). Oral Dis 5: 150–155.
-
26.
Buchanan JA, Cedro M, Mirdin A, Joseph T, Porter SR, Hodgson TA, 2006. Necrotizing stomatitis in the developed world. Clin Exp Dermatol 31: 372–374.
-
27.
Miglani DC, Sharma OP, 1965. Report of the enquiry “incidence of acute necrotizing ulcerative gingivitis and periodontosis” among cases seen at the Government Hospital. J All India Dent Assoc 37: 183–202.
-
28.
Folayan MO, 2004. The epidemiology, etiology, and pathophysiology of acute necrotizing ulcerative gingivitis associated with malnutrition. J Contemp Dent Pract 5: 28–41.
-
29.
Brattström-Stolt L, Funk T, Sié A, Ndiaye C, Alfvén T, 2019. Noma-knowledge and practice competence among primary healthcare workers: A cross-sectional study in Burkina Faso. Int Health 11: 290–296.
-
30.
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.
-
31.
Farley E et al., 2020. “I treat it but I don’t know what this disease is”: A qualitative study on noma (cancrum oris) and traditional healing in northwest Nigeria. Int Health 12: 28–35.
-
32.
Khammissa RAG, Lemmer J, Feller L, 2021. Noma: A neglected oro-facial childhood disease. Lancet Child Adolesc Health 5: 685–686.
-
33.
Gebretsadik HG, 2024. Noma is a facial disfiguring childhood disease: Insights from cases of noma in Ethiopia. Int J Pediatr Otorhinolaryngol 177: 111845. Epub 2024 Jan 1. PMID: 38176115.
-
34.
Gebretsadik HG, 2023. Impact of erroneous belief on timely health care-seeking practices among noma (facial gangrene) survivors in Ethiopia. J Orthop Sports Med 5: 226–231.
-
35.
Vinetz JM, 2008. Missing the forest for the trees in biomedical research: The example of noma. Am J Trop Med Hyg 78: 535.
-
36.
World Health Organization, 2023. Noma. Available at: https://www.who.int/news-room/fact-sheets/detail/noma. Accessed July 2, 2024.
-
37.
Lee H, 2013. Procalcitonin as a biomarker of infectious diseases. Korean J Intern Med 28: 285–291.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 731 | 731 | 353 |
| Full Text Views | 18 | 18 | 11 |
| PDF Downloads | 28 | 28 | 17 |
Clinical Diagnosis of Acute Noma: Essential Infection Markers and Clinical Presentations
Heron Gezahegn Gebretsadik
gezahegn.heron@gmail.com
Heron Gezahegn Gebretsadik
School of Global Health & Bioethics, Euclid University, Banjul, Gambia
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ABSTRACT.
In clinical settings, understanding the markers and clinical signs of infection is critical for timely diagnosis and treatment. However, a point-of-care diagnostic test is lacking for noma, a debilitating orofacial infectious disease. This retrospective study reviewed electronic medical records (EMRs) and paper medical records (PMRs) of noma patients from Facing Africa (235 EMRs), Yekatit 12 Hospital (68 PMRs), and Project Harar (33 PMRs) in Ethiopia to identify essential infection markers and clinical presentations of acute noma. The review identified seven acute noma patients aged 4–9 years. The patients presented with facial edema, pain, anorexia, ecchymosis, excessive salivation, and drooling, as well as specific symptoms such as visual disturbances, high fever, foul odor, halitosis, and local tenderness. Laboratory findings included elevated white blood cell counts (13,500–14,500 cells/mcL), C-reactive protein levels (107–148 mg/L), and erythrocyte sedimentation rates (65–90 mm/hour). At >85 ng/mL, procalcitonin levels were particularly high. Accurate diagnosis of noma requires a comprehensive approach that includes thorough clinical examination, appropriate disease stage classification, medical history review, and laboratory testing. The study highlights the critical infection markers and clinical presentations associated with acute noma that may aid in early diagnosis of the disease. Further research with a much larger number of participants is needed. However, given the difficulty in identifying acute noma cases due to the rapid progression and very high mortality of the disease and the challenge of accessing acute noma cases owing to various socioeconomic barriers, the results of this small study are still relevant.
Author Notes
Disclosure: The Addis Ababa Health Bureau IRB Ethics Committee approved the study (approval no. A/A/H/B/2116/227). Patient confidentiality was ensured by using patients’ initials on the Excel spreadsheet for data extraction. All participants, or their guardians for minors, signed consent forms allowing their medical information and photographs to be used for research and publication.
Current contact information: Heron Gezahegn Gebretsadik, School of Global Health & Bioethics, Euclid University, Banjul, Gambia, E-mails: gebretsadik@euclidfaculty.net or gezahegn.heron@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Shaye DA, Winters R, Rabbels J, Adentunji AS, Magee A, Vo D, 2019. Noma surgery. Laryngoscope 129: 96–99.
-
2.
Prado-Calleros HM, Castillo-Ventura BB, Jiménez-Escobar I, Ramírez-Hinojosa JP, López-Gómez A, García-de-la-Cruz M, Dayan-Nurko M, 2018. Noma and noma-like disease in HIV/AIDS patients, a comorbid interaction: A systematic review. J Infect Dev Ctries 12: 89–96.
-
3.
Gebretsadik HG, 2023. Shattered Smiles: The FACES of NOMA. Berlin, Germany: LAP LAMBERT Academic Publishing.
-
4.
Dufty J, Gkranias N, Donos N, 2017. Necrotising ulcerative gingivitis: A literature review. Oral Health Prev Dent 15: 321–327.
-
5.
Nash ES, Cheng LHH, Smart K, 1991. Cancrum oris-like lesions. Br J Oral Maxillofac Surg 29: 51–53.
-
6.
Enwonwu CO, Falkler WA Jr, Idigbe EO, 2000. Oro-facial gangrene (noma/cancrum oris): Pathogenetic mechanisms. Crit Rev Oral Biol Med 11: 159–171.
-
7.
Gollapudi M, Mohod S, Pankey N, Gatlewar P, 2024. Acute necrotizing ulcerative gingivitis: A case report. Cureus 16: e63023.
-
8.
Ashok N, Tarakji B, Darwish S, Rodrigues JC, Altamimi MA, 2015. A review on noma: A recent update. Glob J Health Sci 8: 53–59.
-
9.
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.
-
10.
Faye O, Keita M, N’diaye HT, Konare HD, Darie H, Keita S, Mahe A, 2003. Noma chez des adultes infectés par le VIH [Noma in HIV-infected adults]. Ann Dermatol Venereol 130: 199–201.
-
11.
Srour ML, Farley E, Mpinga EK, 2022. Lao noma survivors: A case series, 2002–2020. Am J Trop Med Hyg 106: 1269–1274.
-
12.
Miller LE, Shaye DA, 2021. Noma and necrotizing fasciitis of the face and neck. Facial Plast Surg 37: 439–445.
-
13.
Srour ML, Baratti-Mayer D, 2020. Why is noma a neglected-neglected tropical disease? PLoS Negl Trop Dis 14: e0008435.
-
14.
Bourgeois DM, Leclercq MH, 1999. The World Health Organization initiative on noma. Oral Dis 5: 172–174.
-
15.
World Health Organization, 2016. NOMA Is a Severe Disease It is Treatable If Detected and Managed Early! Available at: https://www.afro.who.int/sites/default/files/2017-07/Information_brochure_EN.pdf. Accessed April 26, 2024.
-
16.
Maley A, Desai M, Parker S, 2014. Noma: A disease of poverty presenting at an urban hospital in the United States. JAAD Case Rep 1: 18–20.
-
17.
Farley E et al., 2021. Noma, a neglected disease: A viewpoint article. PLoS Negl Trop Dis 15: e0009437.
-
18.
Caulfield A, Alfvén T, 2020. Improving prevention, recognition and treatment of noma. Bull World Health Organ 98: 365–366.
-
19.
Gupta A, Sardana K, Gautam RK, 2018. An unusual case of noma caused by Klebsiella pnuemoniae and its management. Trop Doct 48: 230–232.
-
20.
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.
-
21.
Madabhavi I, Revannasiddaiah S, Sarkar M, 2018. Cancrum oris (noma): An early sign of acute lymphoblastic leukemia relapse. Indian J Dermatol Venereol Leprol 84: 373.
-
22.
Srour ML, Marck KW, Baratti-Mayer D, 2015. Noma: Neglected, forgotten and a human rights issue. Int Health 7: 149–150.
-
23.
Khammissa RAG, Lemmer J, Feller L, 2022. Noma staging: A review. Trop Med Health 50: 40.
-
24.
Bourgeois DM, Diallo B, Frieh C, Leclercq MH, 1999. Epidemiology of the incidence of oro-facial noma: A study of cases in Dakar, Senegal, 1981–1993. Am J Trop Med Hyg 61: 909–913.
-
25.
Falkler WA Jr, Enwonwu CO, Idigbe EO, 1999. Microbiological understandings and mysteries of noma (cancrum oris). Oral Dis 5: 150–155.
-
26.
Buchanan JA, Cedro M, Mirdin A, Joseph T, Porter SR, Hodgson TA, 2006. Necrotizing stomatitis in the developed world. Clin Exp Dermatol 31: 372–374.
-
27.
Miglani DC, Sharma OP, 1965. Report of the enquiry “incidence of acute necrotizing ulcerative gingivitis and periodontosis” among cases seen at the Government Hospital. J All India Dent Assoc 37: 183–202.
-
28.
Folayan MO, 2004. The epidemiology, etiology, and pathophysiology of acute necrotizing ulcerative gingivitis associated with malnutrition. J Contemp Dent Pract 5: 28–41.
-
29.
Brattström-Stolt L, Funk T, Sié A, Ndiaye C, Alfvén T, 2019. Noma-knowledge and practice competence among primary healthcare workers: A cross-sectional study in Burkina Faso. Int Health 11: 290–296.
-
30.
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.
-
31.
Farley E et al., 2020. “I treat it but I don’t know what this disease is”: A qualitative study on noma (cancrum oris) and traditional healing in northwest Nigeria. Int Health 12: 28–35.
-
32.
Khammissa RAG, Lemmer J, Feller L, 2021. Noma: A neglected oro-facial childhood disease. Lancet Child Adolesc Health 5: 685–686.
-
33.
Gebretsadik HG, 2024. Noma is a facial disfiguring childhood disease: Insights from cases of noma in Ethiopia. Int J Pediatr Otorhinolaryngol 177: 111845. Epub 2024 Jan 1. PMID: 38176115.
-
34.
Gebretsadik HG, 2023. Impact of erroneous belief on timely health care-seeking practices among noma (facial gangrene) survivors in Ethiopia. J Orthop Sports Med 5: 226–231.
-
35.
Vinetz JM, 2008. Missing the forest for the trees in biomedical research: The example of noma. Am J Trop Med Hyg 78: 535.
-
36.
World Health Organization, 2023. Noma. Available at: https://www.who.int/news-room/fact-sheets/detail/noma. Accessed July 2, 2024.
-
37.
Lee H, 2013. Procalcitonin as a biomarker of infectious diseases. Korean J Intern Med 28: 285–291.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 731 | 731 | 353 |
| Full Text Views | 18 | 18 | 11 |
| PDF Downloads | 28 | 28 | 17 |