Sokoto: Children affected by noma are continuing to arrive at specialist hospitals in northern Nigeria with severe facial injuries, while health workers stress the importance of identifying and treating the disease before it causes permanent damage.
At the Noma Children Hospital in Sokoto State, Doctors Without Borders, known by its French initials MSF, supports reconstructive surgery and other care for people affected by the disease. More than 500 children with noma were treated at the hospital between 2023 and 2025, according to hospital data.
Noma is a severe disease that affects the mouth and face. It can begin with inflammation of the gums and, in serious cases, destroy soft tissue and bone. It mainly affects vulnerable children, particularly those living in extreme poverty and experiencing malnutrition, poor oral health and limited access to healthcare.
The disease can often be stopped when it is identified and treated early. Treatment can include antibiotics, wound care and nutritional support. Children who reach medical care after extensive tissue damage may require reconstructive surgery and several operations.
New research has provided a clearer picture of the scale and geographical distribution of noma in northern Nigeria. A study published in The Lancet Global Health on May 8, 2026, estimated 50,782 incident noma cases between 1999 and 2024 across 296 local government areas in 12 northern Nigerian states.
The figure is a modelled estimate rather than a direct count of confirmed cases. Researchers based their analysis on records from 911 patients with complete data who were treated for acute noma at the Noma Children Hospital in Sokoto between September 1999 and October 2024. They combined the hospital data with population and geographical information to estimate the distribution of the disease.
The estimate covers the period up to 2024 and does not represent the number of noma cases currently being treated in Nigeria in 2026.
The study found particularly high estimated risks in northwestern Nigeria. In Sokoto State, 20 of 23 local government areas had significantly elevated estimated incidence risks. Similar patterns were found in 12 of 14 local government areas in Zamfara State and 13 of 21 in Kebbi State.
The findings identify communities where earlier detection, prevention and access to treatment could be particularly important.
Health workers have also raised concerns about children reaching hospitals after the disease has already caused serious damage. MSF's Nigeria medical coordinator, Bukola Oluyide, said health workers were seeing more acute noma cases and stressed the need for earlier treatment.
A 2026 study of 419 healthcare workers in Sokoto and Kebbi states also found limited clinical experience with noma. The study found that 96 per cent of participants were interested in learning more about the disease.
Noma has received greater international attention since the World Health Organization officially added it to its list of neglected tropical diseases in December 2023.
WHO describes noma as a severe and often fatal disease that mainly affects vulnerable and marginalised populations. Poverty, malnutrition, poor oral health, inadequate sanitation and limited access to healthcare are among the conditions associated with the disease.
In July 2026, WHO issued new technical guidance on noma control. The guidance calls for early detection and treatment as well as better nutrition, oral healthcare, water and sanitation, community awareness and stronger disease surveillance.
Noma remains difficult to measure globally. WHO has said that its true worldwide distribution and burden are not known because many cases are not detected or reported. The widely cited global estimate of about 140,000 new cases a year dates from 1998.
WHO has also historically estimated that up to 90 per cent of untreated noma cases can be fatal. This figure should not be interpreted as a current national mortality rate for Nigeria. It is a historical estimate for untreated disease.
For survivors who receive treatment after extensive facial damage, recovery can take years. Some require several operations to restore their ability to eat, speak or breathe normally. The physical effects can also expose survivors to stigma and social isolation.
Eight year old Ibrahim Dalhatu is among those who have received treatment in Sokoto. He contracted noma when he was three and had his first reconstructive operation in 2021. He has since undergone six operations and is now able to eat and speak normally following surgery to repair a nasal opening.
Other children continue to wait for treatment. A 4 year old boy who contracted noma in 2024 has severe facial damage and is waiting for surgery because doctors at the hospital consider him too young for the procedure.
Nigeria has specialist noma treatment facilities in Sokoto and Abuja. The Sokoto hospital remains an important centre for patients from northern states, while government and humanitarian organisations continue to support treatment and awareness efforts.
The latest research highlights the importance of looking beyond the treatment of advanced cases. Earlier recognition, better nutrition, stronger primary healthcare services and greater community awareness are important parts of efforts to control the disease.
For communities affected by poverty and limited access to healthcare, identifying noma at an early stage can make a major difference. The new research on its geographical distribution, together with WHO's 2026 guidance, points to the need for stronger prevention, early treatment and surveillance to reduce the impact of the disease on children in Nigeria.