Noma, whose name comes from the Greek “devour”, is a form of facial gangrene (tissue death, or necrosis) which mainly affects children suffering from malnutrition, poor general health and poor oral hygiene. According to the World Health Organization (WHO), approximately 140 people are affected by this disease each year in the world.

The noma, also called cancer of the mouth, begins with a lesion in the mouth, which spreads and quickly destroys surrounding tissues such as the lining of the mouth, muscles and even the bones of the cheek, jaw, and even the nose. The gangrenous tissue dies and falls away, leading to severe facial mutilation.

Without treatment, this terrible disease is almost always fatal.

Causes of the disease

The exact cause of noma is unknown. Little research is done on the disease and it is still unclear how it starts.¹.

In most cases, people with the disease are not seen by a doctor or are seen very late, when the lesions are already extensive.

This is most likely an infection caused by several microorganisms. Harmful bacteria of type spirochète et fusobacterium are often found in the lesions, but many other bacteria such as Staphylococcus aureus could also be involved².

At the same time, other factors contribute to the development of noma, in particular³ :

• malnutrition
• various infections (especially measles, malaria and HIV infection)
• lack of hygiene

Thus, those affected live in conditions of extreme poverty and are in poor health (viral infection, malnutrition, dehydration, etc.).

Who is affected?

In the past, noma, sometimes referred to as “the face of poverty”, was prevalent all over the world, including Europe and North America.

Today, cases of noma occur exclusively in the poorest populations, and particularly in West Africa and India. Cases are also reported in South America and Southeast Asia.

In addition, 90% of cases occur in children under 10 years old.¹. Undernourished children aged 2 to 5 are the most affected (see the section Noma statistics).

Course and possible complications

Without treatment, the death rate of noma reaches 80 to 90%⁴.

People who survive routinely suffer severe facial mutilation. A majority of them are unable to eat, speak and breathe normally.

The scarring of the lesions often leads to permanent constriction of the jaws (the muscles of the jaw are constantly contracted, making it very difficult to open).

Victims of noma are sometimes rejected by their community, as the disease is often seen as a curse. The children who have survived are therefore subject to anxiety, a feeling of guilt and a withdrawal into themselves which are added to the functional difficulties of nutrition and language.