Assessing the rarity of noma in Ethiopia: Estimating cumulative point prevalence of the devastating childhood disease

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BACKGROUND: Noma, a severe and often fatal disease, is poorly understood due to limited data. Recently classified as a neglected tropical disease by WHO, its status in Ethiopia remains unclear. This study estimates Ethiopia's cumulative point prevalence of noma. METHODS: In a retrospective cross-sectional study, the disease incidence in Ethiopia was determined using data from the review of medical records of noma cases. The medical records were obtained from the three main centers for treating noma in Ethiopia. Disease duration, which is critical for estimating point prevalence, was determined based on existing literature. Mean annual incidence data and disease duration were used to calculate the point prevalence of noma in 2019. This was translated into a ratio per 10,000 total population in Ethiopia to assess the disease status. The UN World Population Dashboard dataset was used to determine the population size of Ethiopia in 2019. RESULTS: The study reviewed 325 medical records from three noma treatment centers in Ethiopia between 2007 and 2019. Noma cases spanned all Ethiopian regions, with Oromia and Amhara accounting for the most cases. An estimated 26,000 cases occurred nationwide during this period, translating to an annual incidence of 2167. The 2019 point prevalence was 0.77 per 10,000 people, confirming noma as a rare disease in Ethiopia. CONCLUSION: This study reveals the rarity of noma in Ethiopia and provides new insights critical to global understanding. Recognition of its rarity underscores the need to redirect resources to mitigate its impact in resource-poor settings such as Ethiopia, where the disease is more prevalent. The findings underscore the need for continued surveillance, data collection, and collaboration to better understand and effectively address noma. Thus, the results of the current study may serve as a landmark baseline data set to re-evaluate traditional perspectives on this devastating disease.

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