Epidemiology of the incidence of oro-facial noma: A study of cases in Dakar, Senegal, 1981-1993

Oro-facial noma is an oral gangrene occurring in early childhood in extreme ly poor areas. As many as 70-90% of those with noma die, and to date, there is no satisfactory treatment to fight this disease. Within the context of the World Health Organization international program against noma,a 13-year retrospective study based on clinical records was carried out in Dakar, Sen egal in an attempt to understand the epidemiology of noma. Between 1981 and 1993, 199 cases of noma were identified, among them; 36.7% were acute case s and 63.3% showed sequelae. Chronic sequelae of noma were seen in patients 2-41 years of age, but the acute phase of noma was found only in young chi ldren (77.7% in those 1-4 years of age, maximum age = 9 years, mean age +/- SD age = 3.4 +/- 1.9 years). A total of 73.1% of the cases with acute dise ase were reported in the Dakar, Diourbel and Kaolack regions during the dry season (57.0% of the cases). The lesions of progressive noma were localize d mainly on the upper lip (42.4%) and the cheek (31.1%). A total of 96.9% o f the patients with acute diseases were had poor general health with seriou s associated diseases; only 20.0% had a good vital prognosis. The developme nt of epidemiologic surveillance programs for noma should be a public healt h priority in Senegal.