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This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Poster presentation

Is noma an infectious disease? Is it transmissible?

A Gayet-Ageron1*, D Baratti-Mayer2, D Courvoisier3, D Pittet1 and GESNOMA1

  • * Corresponding author: A Gayet-Ageron

Author Affiliations

1 Infection Control Program, Geneva, Switzerland

2 University Hospitals Of Geneva, Geneva, Switzerland

3 Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland

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BMC Proceedings 2011, 5(Suppl 6):P251  doi:10.1186/1753-6561-5-S6-P251

The electronic version of this article is the complete one and can be found online at:

Published:29 June 2011

© 2011 Gayet-Ageron et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

Noma is a devastating facial necrosis affecting young children in developing countries. The causative agents are not well identified, in particular the association of noma with specific microbiological agents and the risk for transmission.


Prospective matched case-control study conducted in Zinder, Niger, between September 2001 and October 2006. Epidemiological, socio-behavioural, and biological determinants were collected through interviews with children and their representatives and during clinical examinations. Conditional logistic regression was applied.


A total of 82 acute noma cases and 327 controls were recruited. The noma epidemic curve declined during the study-period (P=0.04) with no seasonal effect (P=0.74). There was no intra-family case, but an older sibling rank was associated with a higher odds of developing noma (OR>=3rd position 3.51; 95%CI: 1.57-7.85). Noma was also associated with severe wasting (OR 7.79; 3.89-15.57), severe stunting (OR 5.22; 2.73-9.97), a higher number of past pregnancies in the mother (OR 1.19 for each additional child; 1.08-1.32), the presence for any other disease within the last 3 months (OR 3.52; 1.89-6.54) or family posses no chicken at home, as aproxy for poverty (OR 2.53; 1.32-4.82). No association was observed between noma and serological status to various viruses (EBV, VZV, HSV, CMV, Morbillivirus). Definitive microbiological data will be available at time of the meeting.


Noma is linked with poor general health status leading to a higher risk to develop opportunistic illnesses, which precipitates the occurrence of devastating facial lesions. No epidemiological evidence was shown for cross-transmission in this cohort- the largest reported to the best of our knowledge.

Disclosure of interest

None declared.