The prevalence of noma in northwest Nigeria.
- Farley E Noma Children's Hospital, Médecins Sans Frontières, Sokoto, Nigeria.
- Oyemakinde MJ Noma Children's Hospital, Médecins Sans Frontières, Sokoto, Nigeria.
- Schuurmans J Noma Children's Hospital, Médecins Sans Frontières, Sokoto, Nigeria.
- Ariti C Centre for Trials Research, Cardiff University School of Medicine, Cardiff, UK.
- Saleh F Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria.
- Uzoigwe G Department of Dentistry, Nigerian Ministry of Health, Abuja, Nigeria.
- Bil K Operational Center Amsterdam Headquarters, Médecins Sans Frontières, Amsterdam, The Netherlands.
- Oluyide B Nigeria Mission, Médecins Sans Frontières, Abuja, Nigeria.
- Fotso A Nigeria Mission, Médecins Sans Frontières, Abuja, Nigeria.
- Amirtharajah M Operational Center Amsterdam Headquarters, Médecins Sans Frontières, Amsterdam, The Netherlands.
- Vyncke J Manson Unit, Médecins Sans Frontières, London, UK.
- Brechard R Manson Unit, Médecins Sans Frontières, London, UK.
- Adetunji AS Department of Clinical Services, Noma Children's Hospital, Sokoto, Nigeria.
- Ritmeijer K Operational Center Amsterdam Headquarters, Médecins Sans Frontières, Amsterdam, The Netherlands.
- van der Kam S Operational Center Amsterdam Headquarters, Médecins Sans Frontières, Amsterdam, The Netherlands.
- Baratti-Mayer D Service of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva, Switzerland.
- Mehta U Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, Western Cape, South Africa.
- Isah S Department of Clinical Services, Noma Children's Hospital, Sokoto, Nigeria.
- Ihekweazu C Department of Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria.
- Lenglet A Operational Center Amsterdam Headquarters, Médecins Sans Frontières, Amsterdam, The Netherlands.
- 2020-05-08
Published in:
- BMJ global health. - 2020
English
Background
Noma, a rapidly progressing infection of the oral cavity, mainly affects children. The true burden is unknown. This study reports estimated noma prevalence in children in northwest Nigeria.
Methods
Oral screening was performed on all ≤15 year olds, with caretaker consent, in selected households during this cross-sectional survey. Noma stages were classified using WHO criteria and caretakers answered survey questions. The prevalence of noma was estimated stratified by age group (0-5 and 6-15 years). Factors associated with noma were estimated using logistic regression.
Results
A total of 177 clusters, 3499 households and 7122 children were included. In this sample, 4239 (59.8%) were 0-5 years and 3692 (52.1%) were female. Simple gingivitis was identified in 3.1% (n=181; 95% CI 2.6 to 3.8), acute necrotising gingivitis in 0.1% (n=10; CI 0.1 to 0.3) and oedema in 0.05% (n=3; CI 0.02 to 0.2). No cases of late-stage noma were detected. Multivariable analysis in the group aged 0-5 years showed having a well as the drinking water source (adjusted odds ratio (aOR) 2.1; CI 1.2 to 3.6) and being aged 3-5 years (aOR 3.9; CI 2.1 to 7.8) was associated with being a noma case. In 6-15 year olds, being male (aOR 1.5; CI 1.0 to 2.2) was associated with being a noma case and preparing pap once or more per week (aOR 0.4; CI 0.2 to 0.8) was associated with not having noma. We estimated that 129120 (CI 105294 to 1 52 947) individuals <15 years of age would have any stage of noma at the time of the survey within the two states. Most of these cases (93%; n=120 082) would be children with simple gingivitis.
Conclusions
Our study identified a high prevalence of children at risk of developing advanced noma. This disease is important but neglected and therefore merits inclusion in the WHO neglected tropical diseases list.
Noma, a rapidly progressing infection of the oral cavity, mainly affects children. The true burden is unknown. This study reports estimated noma prevalence in children in northwest Nigeria.
Methods
Oral screening was performed on all ≤15 year olds, with caretaker consent, in selected households during this cross-sectional survey. Noma stages were classified using WHO criteria and caretakers answered survey questions. The prevalence of noma was estimated stratified by age group (0-5 and 6-15 years). Factors associated with noma were estimated using logistic regression.
Results
A total of 177 clusters, 3499 households and 7122 children were included. In this sample, 4239 (59.8%) were 0-5 years and 3692 (52.1%) were female. Simple gingivitis was identified in 3.1% (n=181; 95% CI 2.6 to 3.8), acute necrotising gingivitis in 0.1% (n=10; CI 0.1 to 0.3) and oedema in 0.05% (n=3; CI 0.02 to 0.2). No cases of late-stage noma were detected. Multivariable analysis in the group aged 0-5 years showed having a well as the drinking water source (adjusted odds ratio (aOR) 2.1; CI 1.2 to 3.6) and being aged 3-5 years (aOR 3.9; CI 2.1 to 7.8) was associated with being a noma case. In 6-15 year olds, being male (aOR 1.5; CI 1.0 to 2.2) was associated with being a noma case and preparing pap once or more per week (aOR 0.4; CI 0.2 to 0.8) was associated with not having noma. We estimated that 129120 (CI 105294 to 1 52 947) individuals <15 years of age would have any stage of noma at the time of the survey within the two states. Most of these cases (93%; n=120 082) would be children with simple gingivitis.
Conclusions
Our study identified a high prevalence of children at risk of developing advanced noma. This disease is important but neglected and therefore merits inclusion in the WHO neglected tropical diseases list.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1136/bmjgh-2019-002141
- PMID 32377404
- Persistent URL
- https://sonar.ch/global/documents/46888
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