Mapping noma in northern Nigeria: spatial modeling and targeted prevention strategy

A study using spatial modeling identified areas of greatest risk for developing one of the most severe infectious diseases of the oral cavity. Noma — a rapidly progressive gangrenous lesion of the soft and hard tissues of the oral cavity and face — remains one of the most understudied pathologies in dentistry. Although Nigeria is most affected by this disease on a global scale, its geographic distribution within the country remained unclear until recently.

Research methodology and identified risk hotspots

A recently conducted study led by Dr. John Adeoye, assistant professor of digital dentistry at the University of Hong Kong, for the first time carried out detailed risk mapping for noma development at the local government level in 12 northern states of Nigeria. The analysis covered 25 years of clinical data collected at the noma children’s hospital in Sokoto.

The researchers identified 64 districts with estimated noma development risk significantly above the average regional level. Particularly critical were 23 contiguous local administrative units in the northwest of the country, which formed a zone of elevated risk.

Clinical manifestations and prognosis

«Before meeting with patients during a surgical expedition, I perceived noma as a historical disease associated with poverty and malnutrition,» Dr. Adeoye said. «I was shocked by how a condition that begins with gum inflammation can rapidly destroy significant portions of the face, and in the absence of treatment, lead to fatal outcome in 80–90% of cases». The resulting color maps show the distribution of estimated risk across age groups, sex, and time periods, which enables health authorities and NGOs to strategically plan public awareness programs, prevention, and early disease detection.

Significance for dental practice

For dentists and other oral health specialists, the significance of this work is particularly great: since noma initially manifests in the oral cavity, dentists and dental therapists are in an ideal position to recognize early signs and urgently refer patients to specialists. The maps indicate where outreach programs, screening, and training of primary health care workers should be concentrated.

Practical implementation of results

Practical application of the results has already begun: the research group, in collaboration with the ZeroNoma initiative in northwestern Nigeria, is training volunteers and using the identified hotspots for targeted screening. Work published in the July issue of *Lancet Global Health* for 2026 continues a series of studies by the team that began in 2019, when noma incidence in central Nigeria was first assessed.

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