TAG: GS 3: ECOLOGY AND ENVIRONMENT
THE CONTEXT: Noma, also known as cancrum oris or gangrenous stomatitis, has been officially recognized by the World Health Organization (WHO) as a neglected tropical disease (NTD).
- This severe gangrenous disease affects the mouth and face, exhibiting an alarming mortality rate of approximately 90%. (Gangrenous: Decaying of a part of body because the blood has stopped flowing there.)
- It is closely associated with extreme poverty, malnutrition, and poor sanitation and oral hygiene, further exacerbating its impact on vulnerable communities.
Characteristics and Impact
- Primarily affecting children between the ages of 2-6 years, Noma displays a severe lack of awareness, with unreliable estimates of cases due to its occurrence in marginalized populations.
- It is named after the Greek word “nomē,” signifying “to devour,” as it progressively consumes facial tissues and bones if left untreated.
Causes and Risk Factors
- The disease is linked to various risk factors, including poor oral hygiene, malnutrition, weakened immune systems, infections, and extreme poverty.
- Although not contagious, Noma preys on individuals with compromised immune defenses.
- It typically initiates with gum inflammation, likely caused by bacteria present in the mouth.
Geographical Prevalence and Historical Context
- Noma predominantly affects children in developing nations, especially in sub-Saharan Africa, where it is primarily observed among impoverished children aged 3-10 years.
- Historical studies indicate that the disease may result from oral contamination by specific bacteria and microbial combinations.
Medical Implications and Challenges
- Early detection is crucial due to Noma’s high mortality rate.
- Basic hygiene, antibiotics, and nutritional support can significantly slow its spread.
- The disease often originates as an ulcer on the mucous membrane, following illnesses like measles.
Consequences and Survivorship
- Survivors of Noma face profound consequences, including severe facial disfigurement, jaw muscle spasms, oral incontinence, and speech impairments.
- Effective treatments such as sulphonamides, penicillin, and surgical interventions remain inaccessible to many due to economic disparities.
Historical Perspective and Eradication Efforts
- Noma was prevalent in earlier centuries but diminished in the Western world with improved nutrition and disease prevention measures.
- Its occurrence in concentration camps during World War II highlights its historical impact.
WHO’s Recognition and Future Prospects
- The inclusion of Noma in WHO’s list of neglected tropical diseases signifies a crucial step toward addressing this overlooked health challenge.
- Médecins Sans Frontières / Doctors Without Borders emphasizes the need for increased attention and resources to combat Noma.
- The WHO aims to raise global awareness, stimulate research, secure funding, and implement comprehensive strategies to control the disease.
Conclusion and Future Endeavours
- Recognition of Noma as an NTD seeks to leverage global attention and multidisciplinary approaches to combat the disease.
- Efforts targeting underserved populations are critical, contributing not only to disease control but also to achieving universal health coverage.
- The WHO’s acknowledgment emphasizes the urgency of addressing Noma and underscores the need for collaborative, multifaceted interventions to mitigate its devastating impact on vulnerable communities.