Recurrence of Noma: Fact or Fiction? A Clinical Review of 34 Patients From Noma Children Hospital, Sokoto, Nigeria

Abstract

OBJECTIVE: Noma is an infectious and potential lethal disease that destroys the orofacial structures in which the etiopathogenesis is not fully understood. Controversy exists about whether noma can recur. The aim of this retrospective study was to evaluate recurrence of noma in patients previously treated for acute phase of noma. METHODS: The authors reviewed the medical records of 34 patients with symptoms of recurrent noma at the Noma Children Hospital, Sokoto, Nigeria. The study included 22 (64.7%) males and 12 (35.3%) females, aged between 3 and 15 years (mean±SD: 7.94±3.03 y). RESULTS: All recurrences occurred at the same anatomic site as the initial presentation. The interval between initial treatment and recurrence ranged from 4 months to 5 years. The most common symptoms at recurrence were pain and ulceration in 12 (35.3%) patients. Necrotic bone was observed in 12 (35.3%) patients, while 22 (64.7%) patients had new fistulas through preexisting noma scars. Initial presentations showed 29 (85.3%) patients with hemoglobin (Hb) below 8 g/dL, compared with only 2 (5.9%) patients with hemoglobin (Hb) below 8 g/dL at recurrence. All patients responded well to antibiotics and wound debridement. CONCLUSION: This study highlights symptoms of recurrent noma at various intervals postinitial treatment. The findings suggest that while initial management is crucial, long-term follow-up is essential to monitor for recurrence and optimize patient outcomes.