■Noma是一种被忽视的热带病和全球健康问题。
■为了阐明流行病学,管理,预防,以及Noma对公共卫生的影响。
■PubMed,Scopus,和WebofScience,由谷歌学者和世界卫生组织数据库补充,使用关键词进行搜索,以收集1970年至2023年的出版文献和灰色文献。
■每年大约发生30,000-40,000例,不同非洲国家的发病率不同,比如尼日利亚,尼日尔,还有乍得.尼日利亚和埃塞俄比亚各州的发病率为每100,000人口0.6至3300和1.64至13.4,分别。尼日尔的死亡率约为8.5%。危险因素包括营养不良,免疫受损状态,牙齿卫生差,卫生条件不足,牙龈病变,社会经济地位低下,慢性和传染病,低出生体重,高奇偶校验,腹泻,和发烧。主要根据临床体征/症状进行诊断,并相应地进行疾病分期。第一阶段,II和II表现为急性坏死性牙龈炎,面部水肿伴口臭,和坏死性口炎,分别。如果病人在急性期存活,第四阶段和第五阶段的进展表现为刺耳,吞咽和发声困难,和面部毁容,在最后阶段增加严重程度。治疗包括抗生素治疗(阿莫西林,甲硝唑,氯己定,氨苄青霉素,庆大霉素),手术干预,伤口管理(蜂蜜敷料,氯胺酮),和营养支持。预防策略包括口腔卫生,疫苗接种,健康教育,以及基于社区的干预措施。
Noma最近被列入世卫组织被忽视的热带病名单,是认识到预防和早期干预对全球增进健康结果的重要性的一个里程碑。
UNASSIGNED: Noma is a neglected tropical disease and a global health concern.
UNASSIGNED: To elucidate the epidemiology, management, prevention, and public health implications of Noma.
UNASSIGNED: 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.
UNASSIGNED: 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.
UNASSIGNED: 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.