{
  "abstract": "Introduction Noma is a rapidly progressing oral infection with a 90% mortality rate if untreated. Early identification by healthcare workers is critical, but limited knowledge can delay diagnosis and timely treatment, leading to severe outcomes. This study assessed healthcare workers’ knowledge, attitudes, perceptions and practices related to noma in northwest Nigeria to inform training and strengthen early detection and response.Methods We conducted a cross-sectional study via interviewer-administered questionnaire in randomly selected health facilities across Sokoto and Kebbi states, Nigeria. Healthcare workers were recruited via convenience sampling. Noma knowledge was assessed using 15 questions, and respondents were categorised based on their scores: very poor (<25%), poor (25–49%), fair (50–74%) or good (≥75%).Results A total of 419 healthcare workers participated in the study. The majority of respondents (n=231, 55%) worked in secondary healthcare facilities. Most of the 419 respondents were community health officers/community health extension workers (n=203, 48%) or nurses (n=177, 42%). Almost all (n=405, 96%) respondents were interested in learning more about noma.Of those who had heard about noma before the study (n=280, 66%), most had poor (25–49% score, n=165, 59%) or fair (50–74% score, n=100, 36%) knowledge about noma. Few (n=55, 19%) respondents reported ever treating noma patients. Most healthcare workers reported that early-stage noma treatments were available in their facilities: antibiotics (n=255, 91%), nutritional support (n=213, 76%) and wound debridement (n=199, 71%).Conclusion Our study highlights a significant knowledge gap about noma among healthcare workers in northwest Nigeria, despite limited clinical experience. Encouragingly, there is strong interest in learning and acceptance of educational tools. This presents a valuable opportunity to enhance training and early detection. Strengthening awareness and capacity is crucial, as timely intervention during the early, reversible stages of noma can greatly reduce associated morbidity and mortality.",
  "authors": [
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Sokoto, Sokoto, Nigeria"
      ],
      "name": "Michael Olaleye"
    },
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Amsterdam, Netherlands"
      ],
      "name": "Mohana Amirtharajah"
    },
    {
      "affiliations": [
        "Medical, The International Noma Network, Cape Town, South Africa, Cape Town, South Africa"
      ],
      "name": "Elise Farley"
    },
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Amsterdam, Netherlands"
      ],
      "name": "Mark Sherlock"
    },
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Sokoto, Sokoto, Nigeria"
      ],
      "name": "Joseph Samuel"
    },
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Sokoto, Sokoto, Nigeria"
      ],
      "name": "Moses Malual"
    },
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Abuja, Abuja, Nigeria"
      ],
      "name": "Miriam Njoki Karinja"
    },
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Sokoto, Sokoto, Nigeria"
      ],
      "name": "Kenneth Enwerem"
    },
    {
      "affiliations": [
        "Medical, Medecins Sans Frontieres Operational Centre Amsterdam, Abuja, Abuja, Nigeria"
      ],
      "name": "Deogracia Kabila"
    },
    {
      "affiliations": [
        "Manson Unit, Medecins Sans Frontieres Operational Centre Amsterdam, London, UK"
      ],
      "name": "Beverley Stringer"
    },
    {
      "affiliations": [
        "Oxon Epidemiology SL, Madrid, Community of Madrid, Spain"
      ],
      "name": "Cono Ariti"
    },
    {
      "affiliations": [
        "Usmanu Danfodiyo University College of Health Sciences, Sokoto, Sokoto, Nigeria"
      ],
      "name": "Taiwo Abdurrazaq"
    },
    {
      "affiliations": [
        "Clinal Services, Noma Children Hospital, Sokoto, Sokoto, Nigeria"
      ],
      "name": "Shafi’u Isah"
    },
    {
      "affiliations": [
        "Clinal Services, Noma Children Hospital, Sokoto, Sokoto, Nigeria"
      ],
      "name": "Adeniyi Semiyu Adetunji"
    },
    {
      "affiliations": [
        "Nigeria Centre for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria"
      ],
      "name": "Fatima Saleh"
    },
    {
      "affiliations": [
        "Nigeria Centre for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria"
      ],
      "name": "Chikwe Ihekweazu"
    },
    {
      "affiliations": [
        "Nigeria Centre for Disease Control and Prevention, Abuja, Federal Capital Territory, Nigeria"
      ],
      "name": "Emmanuel Benyeogor"
    },
    {
      "affiliations": [
        "Manson Unit, Medecins Sans Frontieres Operational Centre Amsterdam, London, UK"
      ],
      "name": "Gregoire Falq"
    }
  ],
  "title": "Healthcare workers’ knowledge, attitudes, perceptions and practices of noma in Northwest Nigeria: a cross-sectional study",
  "uid": "da896fb2-1779-5cba-a993-8b10753246ff"
}