The 130th Annual Meeting of APHA

Abstract #42372

Peter Berthold, DDS, PhD, DMD and Naty Lopez, BSN, MEd, PhD. School of Dental Medicine, University of Pennsylvania, 4001 Spruce Street, Philadelphia, PA 19104-6003, 215-898 0558, berthold@pobox.upenn.edu

Noma or Cancrum Oris, is a "disease of poverty", with etiology in malnutrition, decreased immune response, poor hygienic conditions, measles, and close proximity to household animals. Little is known about this devastating childhood disease although it is an ancient disease with previous global distribution. It is commonly found in sub-Saharan Africa across West and Central Africa from Senegal to Sudan, coinciding with the so-called meningitis belt. Noma starts as an acute, necrotizing gum disease and may spread as uncontrollable, necrotic tissue destruction in the mouth and face. Disease progression is over a few weeks and mortality is high at 70-90%. Accurate data is extremely difficult to obtain but the estimated prevalence is about 1 million cases with an incidence of 100,000-140,000 cases. WHO established its International Action Network Against Noma in 1992 and is actively implementing activities in epidemiology, education, and research and planning the last phase of establishing programs to care for Noma victims. Several NGOs and other institutions are involved in these programs. This report will discuss the Noma program in Niger and Nigeria. The efforts of involved parties have led to increased education through mass media and individualized education in villages in traditional high-risk areas, increased reporting, evaluation of suspicious cases, and care of those afflicted with Noma. In conclusion, increased awareness, education and a working relationship with traditional healers and NGOs have reduced the mortality and increased the number of children who have received care using reconstructive surgery.

Learning Objectives:

• At the end of the presentation, participants will develop an awareness and understanding of Noma, its etiology, disease patterns, geographical distribution and disastrous effects, and to gain information on the efforts of WHO to decrease the incidence in sub Saharan Africa.

Keywords: International Health, Poverty

Related Web page: www.whoafr.org/noma/index.html

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.