[Noma in children in a hospital environment in Bobo-Dioulasso: epidemiologic, clinical and management aspects]

A retrospective study covering ten years (1987-1996) was conducted to assess the epidemiology, clinical features and management of cancrum oris (noma) in children from Burkina Faso. Fifty nine (59) children were admitted with cancrum oris at the paediatrics and maxillo-facial surgery units of Bobo-Dioulasso, the second town of Burkina Faso. The hospital prevalence of noma is 1.5/1000. 81% of the cases were in the 1 to 5 years age group and 58% were females. Predisposing factors include poverty, lack of immunization, malnutrition, bad oral hygiene, measles and parasitic diseases. The cheek was involved in 31% of the cases. Cure was obtained in 80% of patients after medical and surgical treatment. However, many sequels were observed. Post operative outcome is complicated by the children's growth and often results in retractions, recurrence of ulcers or constriction. Psychological and social problems are associated. Management is difficult in our setting because of the lack of information, cost of the treatment and the absence of well-equipped plastic surgery units.