Estimated incidence and Prevalence of noma in north central Nigeria, 2010–2018: A retrospective study

BACKGROUND: Noma is a spreading and fulminant disease believed to be native to Sub-Saharan Africa over the last decade and associated with low socioeconomic status of citizens of the region. Within this noma belt, most epidemiological reports regarding the disease have emanated from the north western region of Nigeria. However, our indigenous surgical mission encountered a substantial number of cases of noma and post-noma defects noteworthy of epidemiological representation across north central Nigeria. METHODS: All noma cases encountered within the 8-year study period were included and divided based on clinical signs into acute and sequelae groups. Incidence estimation was based on acute/recently active cases and was calculated using the statistical method proposed by the WHO Oral Health Unit (1994). Period prevalence of noma was calculated considering the population at risk in the zone. FINDINGS: A total of 78 subjects were included in the study with age ranging from 2–75 years. Twelve subjects (15.4%) presented with acute disease while 66 (84.6%) had various forms of post-noma defects. The estimated incidence of noma in the north central zone was 8.3 per 100000 with a range of 4.1–17.9 per 100000 across various states. Period prevalence of noma which incorporated all cases seen within the study period was 1.6 per 100000 population at risk. CONCLUSION: Although noma may be more prevalent in the north western region of Nigeria, substantial number of cases occurs within the north central zone which calls for deliberate public awareness campaign on disease risk factors and prevention, and education of primary health-care providers.