Burden of Noma (Cancrum Oris) Cases Presenting at Sokoto Noma Hospital: A Retrospective Review

Noma, also known as cancrum oris, is a rapidly progressing gangrenous disease predominantly affecting malnourished children in sub-Saharan Africa, resulting in severe orofacial disfigurement if not treated early. Nigeria, particularly the North West geopolitical zone, accounts for a significant proportion of global noma cases. This retrospective study reviews the clinical burden, demographic profile, nutritional status, triggering factors, and surgical management outcomes of noma cases presenting to Sokoto Noma Hospital, the primary specialist facility dedicated to noma care in Nigeria, over a five-year period from 2019 to 2023. Data were extracted from admission records, clinical notes, and surgical registers, capturing 215 confirmed noma cases. Results indicate that children between two and six years of age constituted 71% of presentations, with severe acute malnutrition documented in 83% of patients. Measles and acute respiratory infections were the most commonly reported triggering illnesses. Most patients presented in the healed scar phase rather than the acute gangrenous phase, suggesting delayed care-seeking. Reconstructive surgeries including scar release, flap repair, and splinting for trismus management were the predominant surgical interventions. Mortality during hospitalization was 8.4%. The study underscores the importance of nutritional intervention programs, childhood vaccination, and community health education in noma-endemic zones of North West Nigeria. Keywords: noma, cancrum oris, Sokoto, orofacial disfigurement, malnutrition.