{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:39:43Z","timestamp":1790919583741,"version":"4.1.0"},"reference-count":50,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,2,8]]},"abstract":"<jats:p>Noma is an orofacial gangrene affecting malnourished children and mainly observed in tropical countries, particularly sub-Saharan Africa. Epidemiological data on noma are scarce, but a current estimate of the global incidence is 30,000\u201340,000 cases per year, with a mortality rate of approximately 85% and a burden of disease calculated to be a loss of 1\u201310 million disability-adjusted life years. The etiology of noma is multifactorial with malnutrition as an ever present factor, often in combination with concomitant diseases, such as measles, malaria, and human immunodeficiency virus (HIV), and poor oral hygiene. The pathogenesis is a fast-spreading, noncontagious gangrenous infection occurring in the face, often preceded by acute necrotizing gingivitis, and stomatitis. Rare microbiological studies suggest an opportunistic infection caused by an imbalance in normal intraoral microorganisms. Prevention lies in food security, measles vaccination, prevention of malaria and HIV, including the early detection and treatment of necrotizing gingivitis and stomatitis. Early treatment with antibiotics may prevent gangrene or reduce its extent. Late treatment consists of surgical rehabilitation, which is often complex. However, access to medical care is very limited for noma patients due to the extremely poor conditions in which they live that are frequently located in remote rural areas. The authors support the United Nations Human Rights Council Resolution 19\/7 adopted on March 22, 2012 \u201cThe right to food,\u201d and advocate for the inclusion of noma on the list of neglected tropical diseases to encourage more medical and institutional attention for this often lethal or very mutilating infectious gangrene.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0718","type":"journal-article","created":{"date-parts":[[2017,1,17]],"date-time":"2017-01-17T01:50:41Z","timestamp":1484617841000},"page":"268-274","source":"Crossref","is-referenced-by-count":106,"title":["Noma: Overview of a Neglected Disease and Human Rights Violation"],"prefix":"10.4269","volume":"96","author":[{"given":"M. Leila","family":"Srour","sequence":"first","affiliation":[{"name":"Health Frontiers, Vientiane, Laos."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaas","family":"Marck","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Medisch Centrum Leeuwarden, Leeuwarden, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Baratti-Mayer","sequence":"additional","affiliation":[{"name":"Geneva Study Group on Noma (GESNOMA), Service of Plastic and Reconstructive Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Lancet Infect Dis","first-page":"419","article-title":"Noma: an \u201cinfectious\u201d disease of unknown aetiology","volume":"3","author":"Baratti-Mayer","year":"2003"},{"key":"ref2","series-title":"Plast Reconstr Surg","first-page":"1702","article-title":"A history of noma, the \u201cface of poverty\u201d","volume":"111","author":"Marck","year":"2003"},{"key":"ref3","series-title":"J Pathol","first-page":"221","article-title":"Observations on the histopathology of cancrum oris","volume":"16","author":"Stewart","year":"1912"},{"key":"ref4","series-title":"Br J Surg","first-page":"949","article-title":"Cancrum oris","volume":"53","author":"Tempest","year":"1966"},{"key":"ref5","series-title":"Lancet","first-page":"147","article-title":"Noma (cancrum oris)","volume":"368","author":"Enwonwu","year":"2006"},{"key":"ref6","article-title":"Le noma aujourd'hui. 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