03140nas a2200349   4500000000100000008004100001260001600042653000900058653003100067653001200098653001500110653001800125100001200143700001300155700001200168700001200180700001700192700001900209700002200228700001600250700001400266700001400280700001600294700001300310700001200323700001900335245012900354856015300483300000900636520213100645022001402776       2024                            d  bElsevier BV10aNoma10aNeglected tropical disease10aPoverty10aPrevention10aPublic Health1 aVerma A1 aZaheer A1 aAhsan A1 aAnand A1 aAbu Serhan H1 aNazli Khatib M1 aSyed Zahiruddin Q1 aGaidhane AM1 aKukreti N1 aRustagi S1 aSatapathy P1 aSharma D1 aArora M1 aKumar Sharma R00aNoma in the WHO's list of neglected tropical diseases: A review of its impact on undeveloped and developing tropical regions  uhttps://www.sciencedirect.com/science/article/pii/S2211335524001797/pdfft?md5=79c9ea7f7eeb91ca2f1187240c01fa48&pid=1-s2.0-S2211335524001797-main.pdf  a1-223 a<p id="st010"><strong>Background:&nbsp;</strong>Noma is a neglected tropical disease and a global health concern.</p>

<p id="st015"><strong>Objectives:&nbsp;</strong>To elucidate the epidemiology, management, prevention, and public health implications of Noma.</p>

<p id="st020"><strong>Methods:&nbsp;</strong>PubMed, Scopus, and Web of Science, supplemented by Google Scholar and World Health Organization databases, were searched using keywords to gather both published and grey literature from 1970 to 2023 in English.</p>

<p id="st025"><strong>Results:&nbsp;</strong>Approximately 30,000–40,000 cases occur annually, with varying incidences across various African countries, such as Nigeria, Niger, and Chad. Incidence in Nigerian and Ethiopian states range from 0.6 to 3300 and 1.64 to 13.4 per 100,000 population, respectively. Mortality is approximately 8.5% in Niger. Risk factors include malnutrition, immunocompromised status, poor dental hygiene, inadequate sanitation, gingival lesions, low socioeconomic status, chronic and infectious diseases, low birth weight, high parity, diarrhoea, and fever. Diagnosis is primarily made based on clinical signs/symptoms and accordingly staging of disease is done. Stage I, II and II presents with acute necrotizing gingivitis, facial edema with halitosis, and necrotizing stomatitis, respectively. If the patient survives acute stages, the progress to Stage IV and Stage V manifests as trismus, difficulty in deglutition and phonation, and facial disfigurement, with increased severity in last stage. Treatment encompasses antibiotic therapy (amoxicillin, metronidazole, chlorhexidine, ampicillin, gentamicin), surgical interventions, wound management (honey dressing, ketamine), and nutritional support. Prevention strategies include oral hygiene, vaccination, health education, and community-based interventions.</p>

<p id="st030"><strong>Conclusion:&nbsp;</strong>Noma’s recent inclusion in WHO list of neglected tropical diseases is a milestone in recognizing the importance of prevention and early intervention to globally enhance health outcomes.</p>
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