Noma (cancrum oris): a forgotten disease of poverty (Noma (cancrum oris) : une maladie oubliée de la pauvreté)
Noma (cancrum oris) is a rapidly progressing, invasive debilitating gangrenous disease of the orofacial region which affects the most vulnerable and marginalized populations worldwide in mainly sub-Saharan Africa but also in some cases in Asia and Latin America. Noma is mainly affecting children aged 2 to 6 years in sub-Saharan Africa. Accurate estimation of noma burden is challenging due to the fast progression with high mortality at an estimated 80-90% without any treatment, weak health systems and disease surveillance, stigma, and a lack of awareness for noma by health care workers and the general population. It is reported to be linked with malnutrition, poor oral hygiene, immunosuppression and living in extreme poverty situations. This presentation addresses the epidemiology, pathogenesis, clinical features, diagnosis, treatment, and public health considerations including the human rights perspective.