Patterns of Noma (Cancrum Oris) Survivors in Ethiopia: A Retrospective, Multicentric, Cross-sectional Study.

Background: Noma is a severe, rapidly progressing necrotizing infection that predominantly affects children in resource-limited settings and can lead to devastating facial disfigurement. Despite its burden, limited data exist on its clinical profile and surgical outcomes in Ethiopia. Methods: We conducted a retrospective study of 103 noma survivors treated during the Facing Africa surgical missions in Ethiopia from 2007 to 2020. Data were collected on sociodemographics, clinical presentation, anatomical involvement, surgical procedures, complications, and follow-up outcomes. Descriptive statistics were used, and comparisons were made with regional data. Results: Of the 103 patients, 51.5% were men, with a mean age of 27.4 years. Most (74.8%) lived in rural areas, and more than 60% lacked formal education. Common clinical issues included eating difficulties (77%), speech challenges (54.4%), and trismus (38.8%). Submental flap (49.5%) and radial forearm free flap (20.4%) were the most common procedures. Postoperative complications included wound infection (22.3%) and flap failure (16.5%). Secondary procedures such as scar revision (66%) and commissuroplasty (32%) were frequently needed. Conclusions: Noma continues to disproportionately affect vulnerable populations in Ethiopia. Although surgical reconstruction is effective, high complication rates and the need for multiple surgical procedures underscore the importance of comprehensive long-term care, including rehabilitation and psychological support.