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‘Noma’: The latest addition to WHO’s list of neglected tropical diseases

  • Category
    Science & Technology
  • Published
    24th Dec, 2023


The severe gangrenous disease of mouth and face has 90% mortality rate and is associated with extreme poverty, malnutrition


WHO and Noma:

  • The World Health Organization (WHO) took a significant step on December 15, 2023, by officially adding noma, a severe gangrenous disease affecting the mouth and face, to its list of neglected tropical diseases (NTD).
  • Commonly known as cancrumoris, noma poses a significant health threat, especially to marginalized children living in extreme poverty.

Neglected Tropical Diseases (NTDs):

  • NTDs are a group of infections that are very common amongst marginalized communities in the developing regions of Africa, Asia and the Americas.
  • They are caused by a variety of pathogens such as viruses, bacteria, protozoa and parasitic worms.
  • NTDs are common in tropical areas where people do not have access to clean water and sanitation.
  • These NTD diseases receive less funding for research and treatment than malaises like tuberculosis, HIV-AIDS and malaria.
  • Examples of NTDs are: snakebite envenomation, scabies, yaws, trachoma, Leishmaniasis and Chagas disease etc

The Severity of Noma

  • High Mortality Rate:Noma, with a mortality rate of approximately 90%, is associated with extreme poverty, malnutrition, poor sanitation, and limited access to oral hygiene.
  • Primary Target: It primarily targets children aged 2-6 years and is prevalent in impoverished communities.

Lack of Awareness and Reliable Data

  • Lack of Awareness: The lack of awareness surrounding noma is compounded by the absence of reliable data.
  • Disease Prevalence: While the WHO estimates 140,000 cases per year with a prevalence of 770,000 cases, the latest data dates back to 1998, emphasizing the hidden and neglected nature of this disease.

Origins and Risk Factors

  • Origin of Disease: The name "noma" is derived from the Greek word "nom?," meaning "to devour," reflecting the disease's ability to consume facial tissue and bones if not treated early.
  • Risk Factors:Noma is linked to poor oral hygiene, malnutrition, weakened immune systems, infections, and extreme poverty.
  • Although not contagious, it tends to strike when the body's defenses are weak.

Global Distribution and Impact

  • Developing Countries:Noma is frequently observed in developing countries, particularly in sub-Saharan Africa, where it disproportionately affects poor children aged 3-10 years.
  • Need for Early Detection: Early detection is crucial due to its high mortality rate, and interventions involving basic hygiene, antibiotics, and nutritional rehabilitation can significantly slow its spread.

Treatment Challenges and Consequences

  • Early treatment:Early treatment is imperative, as noma often starts as an ulcer on the mucous membrane, quickly developing into massive necrosis.
  • Consequences: Survivors face significant consequences, including facial disfigurement, jaw muscle spasms, oral incontinence, and speech problems.
  • Effective drugs and Treatment: Access to effective drugs and surgical treatments remains a challenge, particularly for those in extreme poverty.

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