Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland.
Lancet Infect Dis. 2022 Aug;22(8):e221-e230. doi: 10.1016/S1473-3099(21)00698-8. Epub 2022 Mar 15.
Noma (cancrum oris) is a severely debilitating orofacial disease. The global annual incidence and prevalence figures of noma are outdated and were not based on epidemiological studies. Therefore, we systematically reviewed the scientific literature about the prevalence, incidence, and reported global distribution of noma. We searched ten databases and Google Scholar from 1950 up to Sept 23, 2020. We used an adapted Newcastle-Ottawa scale for quality assessment of the studies we included. Epidemiological data could be extracted from eight publications. Because of the differences in quality and the limited geographical range of the studies, no new estimate of the global incidence and prevalence of noma could be calculated. Our updated world map indicates that patients with noma were diagnosed in at least 23 countries in the past decade. Additionally, we identified a strong focality, with most cases being reported from only a few countries in west Africa. This systematic review has identified a striking scarcity of research and surveillance programmes considering noma. We argue that a first step to noma elimination should be the inclusion of noma in the WHO list of neglected tropical diseases, followed by broad-based integrated control programmes aiming at noma elimination.
坏疽性口炎（cancrum oris）是一种严重的口腔颌面部疾病。全球坏疽性口炎的年发病率和患病率数据已经过时，并且这些数据并非基于流行病学研究。因此，我们系统地回顾了关于坏疽性口炎的患病率、发病率和全球分布的科学文献。我们从 1950 年至 2020 年 9 月 23 日，在 10 个数据库和 Google Scholar 上进行了搜索。我们使用了经过调整的纽卡斯尔-渥太华量表来评估纳入研究的质量。从八项出版物中提取了流行病学数据。由于研究质量的差异以及研究的地理范围有限，因此无法计算出新的全球坏疽性口炎发病率和患病率估计值。我们更新的世界地图表明，在过去十年中，至少有 23 个国家诊断出患有坏疽性口炎的患者。此外，我们还发现了一个强烈的聚集性，大多数病例仅来自西非的少数几个国家。这项系统综述表明，考虑到坏疽性口炎，针对该病的研究和监测计划非常匮乏。我们认为，消除坏疽性口炎的第一步应该是将其纳入世界卫生组织（WHO）的被忽视热带病清单，随后应开展以消除坏疽性口炎为目标的综合性控制计划。
