Noma — MFDS Part 1 MCQ
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Correct answer: B — A malnourished preschool child living in extreme poverty in sub-Saharan Africa
The correct answer is B. Noma is a rapidly progressive gangrenous disease of the oral and facial tissues that predominantly affects young, malnourished children living in extreme poverty, particularly in sub-Saharan Africa. Poor sanitation, limited healthcare access and preceding illnesses such as measles or malaria are frequent associations. Immunosuppressed adults, including those with neutropenia or HIV infection, can develop destructive oral disease and occasional noma-like presentations, but they do not represent the characteristic epidemiological group. Noma is not confined to neonates, and orthodontic appliances are not an established risk factor. Its aetiology appears multifactorial and polymicrobial; attributing it specifically to fusiform bacteria and spirochaetes overstates the available evidence.
Reference: Maguire BJ, Shrestha R, Dahal P, et al. Systematic scoping review of the noma evidence landscape: current knowledge and gaps. BMJ Global Health. 2025;10:e018023. https://pubmed.ncbi.nlm.nih.gov/40744672/