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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Noma: Overview of a Neglected Disease and Human Rights Violation
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Noma: Overview of a Neglected Disease and Human Rights Violation

机译：NOMA：忽视疏忽疾病和侵犯人权的概述

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摘要

Noma is an orofacial gangrene affecting malnourished children and mainly observed in tropical countries, particularly sub-Saharan Africa. Epidemiological data on noma are scarce, but a current estimate of the global incidence is 30,000-40,000 cases per year, with a mortality rate of approximately 85% and a burden of disease calculated to be a loss of 1-10 million disability-adjusted life years. The etiology of noma is multifactorial with malnutrition as an ever present factor, often in combination with concomitant diseases, such as measles, malaria, and human immunodeficiency virus (HIV), and poor oral hygiene. The pathogenesis is a fast-spreading, noncontagious gangrenous infection occurring in the face, often preceded by acute necrotizing gingivitis, and stomatitis. Rare microbiological studies suggest an opportunistic infection caused by an imbalance in normal intraoral microorganisms. Prevention lies in food security, measles vaccination, prevention of malaria and HIV, including the early detection and treatment of necrotizing gingivitis and stomatitis. Early treatment with antibiotics may prevent gangrene or reduce its extent. Late treatment consists of surgical rehabilitation, which is often complex. However, access to medical care is very limited for noma patients due to the extremely poor conditions in which they live that are frequently located in remote rural areas. The authors support the United Nations Human Rights Council Resolution 19/7 adopted on March 22, 2012 "The right to food," and advocate for the inclusion of noma on the list of neglected tropical diseases to encourage more medical and institutional attention for this often lethal or very mutilating infectious gangrene.
机译：Noma是一种影响营养不良儿童的口腔面部坏疽，主要见于热带国家，尤其是撒哈拉以南非洲。关于noma的流行病学数据很少，但目前对全球发病率的估计是每年3万至4万例，死亡率约为85%，疾病负担计算为100万至1000万残疾调整生命年的损失。noma的病因是多因素的，营养不良是一个经常存在的因素，通常与伴随的疾病，如麻疹、疟疾和人类免疫缺陷病毒（HIV）以及不良的口腔卫生相结合。其发病机制是发生在面部的快速传播、非传染性坏疽性感染，通常先于急性坏死性牙龈炎和口腔炎。罕见的微生物学研究表明，机会感染是由正常口腔内微生物失衡引起的。预防工作包括食品安全、麻疹疫苗接种、疟疾和艾滋病毒的预防，包括早期发现和治疗坏死性牙龈炎和口腔炎。早期使用抗生素治疗可以预防坏疽或减少坏疽的程度。晚期治疗包括手术康复，这通常很复杂。然而，由于经常位于偏远农村地区的noma患者生活条件极其恶劣，他们获得医疗服务的机会非常有限。作者支持联合国人权理事会2012年3月22日通过的第19/7号决议“食物权”，并主张将noma列入被忽视的热带疾病名单，以鼓励对这种通常致命或致残性极强的传染性坏疽给予更多医疗和机构关注。

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