Living conditions of children at risk for noma: Nigerian experience

The study reported in this paper was carried out in the Northwestern and So uthwestern regions of Nigeria, between October 1996 and April 1998. The stu dy examined the possible contributory role of living conditions in the deve lopment of acute necrotizing gingivitis (ANG) or noma from oral lesions. Qu estionnaire data obtained from 42 fresh noma cases seen in the Northwest an d four fresh cases seen in the Southwest were examined. In addition 46 case s of advanced ANG from the Southwest were included. The main focus was to c ompare some of the environmental living conditions of cases with advanced A NG and those with noma in these regions. All the noma and ANC cases were se en in children aged 2-12 years. The level of good oral hygiene practices an d general environmental living conditions were significantly higher in the Southwest than in the Northwest. Data also showed that living in close prox imity with livestock was significantly higher in the Northwest than in the Southwest (P < 0.05). The environmental living conditions of children in th e Northwest were further compounded by poor sanitary faecal disposal practi ces as well as minimal access to potable water. The overall data indicated that living in substandard accommodations, exposure to debilitating childho od diseases, living in close proximity to livestock, poor oral hygiene, lim ited access to potable water and poor sanitary disposal of human and animal faecal waste could have put the children in the Northwest at higher risk f or noma than the children in the Southwest. These could have been responsib le for the higher prevalence of noma in the Northwest than in the Southwest .