World Health: mobilization around MSF to fight against Noma, a disease linked to malnutrition

13:05  15 february  2021
13:05  15 february  2021 Source:   rfi.fr

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Supported by Médecins Sans Frontières ( MSF ) since 2014, Sokoto Noma Hospital is the only facility in the country – and one of the few in the world – fully dedicated to treating this deadly bacterial disease . Children with malnutrition , poor oral hygiene or suffering from childhood diseases such as measles are particularly susceptible to noma , as confirmed by recent research into the disease by MSF . Having no access to healthcare is another risk factor, directly linked to the difficulties of detecting it early.

Noma (also known as cancrum oris) is a rapidly progressive, often gangrenous, infection of the mouth and face. The mucous membranes of the mouth develop ulcers, and rapid, painful tissue degeneration ensues, which can degrade tissues of the bones in the face.

Un enfant dans un centre de lutte contre la malnutrition. (Image d'illustration) © FLORENT VERGNES AFP / File A child in a center to fight against malnutrition. (Illustrative image)

A group of NGOs and practitioners led by Médecins sans frontières calls for greater consideration of Noma, and more resources to treat it and even make it disappear. This disease, which is primarily linked to malnutrition and other infectious diseases (measles, malaria, HIV), attacks the mouth, jaw and face, like gangrene. It still affects some 140,000 children each year in areas of the world hit by extreme poverty, particularly in the Sahel. Without care, it is almost certainly fatal.

Noma begins with gingivitis, which under the effect of malnutrition and poor hygiene, will degenerate and attack the jaw, muscles, teeth, facial tissue. Without early treatment of the infection, between 80 and 90% of patients die in terrible suffering within two weeks.

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Malnutrition occurs when a person does not receive adequate nutrients from diet. This causes damage to the vital organs and functions of the body. Lack of food is the most cause of malnutrition in the poorer and developing countries. Some medications tend to alter the body’s ability to absorb and break down nutrients and taking these may lead to malnutrition . The demand for energy from food exceeds the amount of food taken. This includes those who have suffered a serious injury, burn or after major surgical procedures.

Malnutrition is the key risk factor of noma , a disease that devours the face of children and is fatal in up to 90 per cent of cases if basic, cost-effective treatment is not administered early on. 16. Infants and young children are the most vulnerable to malnutrition because of their high nutritional requirements for growth and cognitive development and their often vulnerable place in society.32 Malnutrition as a stand-alone condition and in relation to other childhood diseases – be they chronic, acute or severe complications – contributes significantly to the premature death of children.

However, a simple and early treatment is enough, recalls Dr. Denise Barratti-Mayer, of the University of Geneva, specialist in this disease: “The face will swell and this is really the last moments when we can act with a very simple treatment: hydration, nutrition and some antibiotics. It will stop the disease by preventing the destruction of the face. "

In the affected regions, knowledge of the disease and access to healthcare facilities remain limited. Those who survive, disfigured, disabled, are often ostracized. In Burkina Faso, for example, the Sahel and Center-East regions, where insecurity is added to extreme poverty, are experiencing the highest number of cases of a disease that could yet be eradicated.

“The necessary means, as we all know, is the fight against poverty. It is also necessary to give advice to the populations, to vaccinate the children on time. Children must be fed to fight against malnutrition and ensure good oral hygiene, ”explains Dr Rose Drabo, is responsible for the fight against Noma at the Burkinabè Ministry of Health.

To obtain more human and material resources, Noma specialists are calling for its inclusion in the list of neglected tropical diseases of the World Health Organization (WHO). And to support the fight against Noma, Médecins sans Frontières supported the documentary “Restoring dignity” which follows survivors of the disease treated by MSF in northern Nigeria.

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