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A new paper conducted by the Infectious Disease Data Observatory and the World Health Organization has revealed major gaps in research on noma, a severe and often fatal oral disease affecting children in low-resource settings. The review analysed 366 studies to provide a comprehensive foundation for future research and policy action.

A male doctor examining a boy in Africa

Noma is a severe gangrenous disease of the mouth and oro-facial structures that can cause disfigurement and serious health issues. It is often fatal if left untreated. Noma primarily affects young children who live in areas with limited healthcare, affected by food insecurity. If diagnosed early, the progression of noma can be stopped with antibiotic treatment. Later phases of the disease will require surgery.

Noma was recognised as a neglected tropical disease by the World Health Organization (WHO) in December 2023. This followed sustained efforts from 32 countries, led by Nigeria, civil society organisations and noma survivors. However, there has been little research into the condition, which means there are still significant gaps in understanding the causes, risk factors, the global burden and optimal treatment for noma. This knowledge gap is exacerbated due to underreporting, as many affected individuals do not get access to healthcare in time. 

Historically, the disease has been thought to be mainly endemic in Sub-Saharan Africa between Mauritania and Ethiopia (the ‘noma belt’), but recent reports continue to identify noma cases in other parts of the world.

In this comprehensive review, Infectious Disease Data Observatory (IDDO) researchers in collaboration with WHO conducted a review of all primary research publications on noma, unrestricted by study design. The systematic review retrieved 366 publications – published between 1839 and 2022 – which included a total of 15,082 patients.

The study concluded that substantial research gaps remain regarding the aetiology, pathogenesis, disease burden and treatment of noma, highlighting the need for standardised reporting, increased surveillance and improved early detection.

 

Read the full story on the Nuffield Department of Medicine website.

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