       Document 0537
 DOCN  M9610537
 TI    Noma: a neglected scourge of children in sub-Saharan Africa.
 DT    9601
 AU    Enwonwu CO; University of Maryland, Baltimore 21201, USA.
 SO    Bull World Health Organ. 1995;73(4):541-5. Unique Identifier : AIDSLINE
       MED/96040933
 AB    Poverty is the single most important risk indicator for noma (cancrum
       oris), a severe gangrene of the soft and hard tissues of the mouth,
       face, and neighbouring areas. The risk factors associated with an
       increased probability of noma developing include the following:
       malnutrition, poor oral hygiene, and a state of debilitation resulting
       from human immunodeficiency virus (HIV) infection, measles, and other
       childhood diseases prevalent in the tropics. There are many similarities
       between noma and necrobacillosis of the body surface of wallabies
       (Macropus reforgriseus), and it is proposed that noma results from oral
       contamination by a heavy load of Bacteroidaceae (particularly
       Fusobacterium necrophorum) and a consortium of other microorganisms.
       These opportunistic pathogens invade oral tissues whose defences are
       weakened by malnutrition, acute necrotizing gingivitis, debilitating
       conditions, trauma, and other oral mucosal ulcers. The current
       escalation in the incidence of noma in Africa can be attributed to the
       worsening economic crisis in the region, which has adversely affected
       the health and well-being of children through deteriorating sanitation,
       declining nutritional status and the associated immunosuppression, and
       increased exposure to infectious diseases. Prevention of noma in Africa
       will require measures that address these problems, and most importantly,
       eliminate faecal contamination of foods and water supplies.
 DE    Africa South of the Sahara/EPIDEMIOLOGY  Bacteroidaceae/PATHOGENICITY
       Child  Human  Noma/*EPIDEMIOLOGY/ETIOLOGY/MICROBIOLOGY  Nutrition
       Disorders/COMPLICATIONS  Oral Hygiene  Risk Factors  Support, U.S.
       Gov't, P.H.S.  Virulence  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

