Srour Margaret Leila, Farley Elise, Mpinga Emmanuel Kabengele
Health Frontiers, Vientiane, Laos.
Nudibrink Research Consultancy, Cape Town, South Africa.
Am J Trop Med Hyg. 2022 Feb 28;106(4):1269-1274. doi: 10.4269/ajtmh.21-1079. Print 2022 Apr 6.
Noma is a rapidly progressing infection of the oral cavity, mostly affecting children aged between 2 and 5 years. If untreated, mortality can reach 90% within a few weeks after the onset of symptoms. Most of the published literature on noma are case reports or case series from Africa. Studies including noma survivors in Asia are limited. We present a case series of noma survivors in Laos. A retrospective analysis of data collected to monitor the care provided to Lao noma survivors who presented for treatment from 2002 to 2020 was conducted. The review assessed data including sociodemographic characteristics, diagnosis, mouth opening, self-reported quality of life at admission and after surgery, and the names used for the disease. Of the 50 patients included, 25 (50%) were female. The median age of self-reported onset of acute noma was 4 years (interquartile range [IQR] 2-7 years). The noma survivors came from 14/17 (82%) of Lao provinces. There were 64 surgeries conducted on 45 of these survivors. There was a median of 25 years (IQR 16-33 years) between the time of acute infection and the provision of surgical care. Improvements in nutritional status and quality of life were evident after surgery. Patients referred to the disease as "Pak Phuey," which means diseased mouth. Noma survivors frequently live for years with disabling sequelae. Surgical rehabilitation improves the quality of life for noma survivors.
坏疽性口炎是一种进展迅速的口腔感染疾病，主要影响2至5岁的儿童。若不治疗，症状出现后的几周内死亡率可达90%。关于坏疽性口炎的已发表文献大多是来自非洲的病例报告或病例系列。包含亚洲坏疽性口炎幸存者的研究有限。我们呈现了老挝坏疽性口炎幸存者的病例系列。对2002年至2020年期间前来接受治疗的老挝坏疽性口炎幸存者所接受护理的监测数据进行了回顾性分析。该综述评估的数据包括社会人口学特征、诊断、开口度、入院时和手术后自我报告的生活质量，以及该疾病的名称。纳入的50例患者中，25例（50%）为女性。自我报告的急性坏疽性口炎发病的中位年龄为4岁（四分位间距[IQR]2 - 7岁）。这些坏疽性口炎幸存者来自老挝17个省份中的14个（82%）。其中45名幸存者共接受了64次手术。从急性感染到接受手术治疗的时间中位数为25年（IQR 16 - 33年）。手术后营养状况和生活质量有明显改善。患者将该疾病称为“Pak Phuey”，意思是患病的嘴巴。坏疽性口炎幸存者常常带着致残后遗症存活多年。手术康复改善了坏疽性口炎幸存者的生活质量。
