Lancet Study Maps 64 New High-Risk Noma Zones Across Northern Nigeria

Researchers from HKU and Nigerian partners modeled noma incidence risk across 296 northern LGAs using clinical records from the Noma Children’s Hospital. They produced age-, sex-, and stage-stratified estimates that revealed a major northwestern cluster and 64 additional hotspots where incidence had been undercounted. The maps supply the first small-area risk surfaces suitable for resource allocation in a country long believed to carry one of the world’s highest noma burdens. Noma carries an 80–90 % case-fatality rate when untreated and was added to the WHO neglected tropical disease list only in 2023. Nigeria’s true distribution remained opaque because cases cluster in the poorest communities and rarely reach formal surveillance. The new estimates therefore expose both the scale of underreporting and the geographic concentration that standard national aggregates had masked. The work supplies a replicable modeling framework for other endemic African settings and has already seeded partnerships with the ZeroNoma Initiative. Digitized risk layers are now being used to site community surveillance and early-treatment teams. Sustained impact will require prospective validation against active case-finding data and integration into Nigeria’s neglected-disease control budgets. Next steps include a planned 2027–2028 prospective cohort in the 23-LGA cluster to test whether targeted case-finding reduces progression to stage 3–4 disease by at least 30 %.