‘Astonishing’ discovery could help save children from deadly disfiguring condition | Global development

Researchers hope the “surprising” discovery of a new bacterium could open the door to better ways to prevent, detect and treat a deadly and disabling childhood disease.

Noma, which is Fatal in 90% of untreated casesIt starts as pain in the gums and continues by destroying the oral and facial tissues.

It mostly affects young, poor and malnourished children and has been called the “face of poverty”. Survivors face lifelong scarring and disfigurement. Data from Noma is patchy, but expert estimates show case numbers as follows: tens of thousands every year. Most cases are reported in the Sahel region of Africa, but they also occur in other parts of the world.

Although it can be successfully treated with broad-spectrum antibiotics, it points to a bacterial culprit; The exact underlying cause of noma; neglected tropical diseasehas never been established.

Research led by Liverpool School of Tropical Medicine I set to work Bacterial community living in the mouth of noma patients using samples from 19 children in Nigeria.

Modern genetic analysis techniques have revealed an apparently disturbed community of microbes, with normal, healthy bacteria at lower levels but other species greatly increased. Deeper analysis revealed a previously undescribed species. treponema bacteria in most of the Noma patient samples.

When PhD student Angus O’Ferrall, who put together the data and identified the species in the samples, presented the results, Prof Adam Roberts, one of the study’s senior authors, said it was a “wonderful explanation”. “I was surprised,” he said.

Scientists went on to reanalyze old samples from other noma patients and found: treponema bacteria – currently called Treponema A – these were also available.

“We don’t know the causal relationship,” Roberts emphasized. “We don’t know if it can colonize a noma wound or cause a noma wound because of the architecture and environment.”

The team is now trying to answer this question with a larger study using samples from more noma patients and healthy individuals living in the same communities across multiple countries.

According to Roberts, once the noma progresses to the necrotic stage, there are only two paths for the patient. They are either treated quickly with antibiotics “and you usually get a good recovery, but you end up with severe disfigurement – and with that comes lifelong stigma and social exclusion – or death. We want to stop it from reaching that point.”

In the future, a test will be developed to detect the presence of gingivitis in children with gingivitis. Treponema A Roberts hopes this could save them from either fate.

“All we have right now is a clinical diagnosis based on symptoms. And that could be a bad smell.” [or] “There are holes in the skin and tissues,” he said. “But if we actually know that Treponema A“For example, if the gingivitis stage is always or 99% associated with the development of noma, we can detect it and treat it prophylactically with antibiotics to stop its progression.”

Current treatment for noma, using broad-spectrum antibiotics, carries the risk of increasing antimicrobial resistance, Roberts said. A targeted therapy that targets a specific bacterium could reduce this threat.

He added that the decline in healthy bacteria seen in Noma patients raises the possibility of “potential preventive intervention” with probiotics.

The study was published in the journal Plos Neglected Tropical Diseases and also involved researchers from the University of Liverpool, Médecins Sans Frontières and Noma children’s hospital in Sokoto, Nigeria.

Dr., senior research fellow in global health at the University of Southampton, who was not involved in the research. Michael Head said the findings were a useful first step towards understanding the “currently mysterious condition”. “A different version of this treponema The bacteria causes syphilis, known as a sexually transmitted infection, but it can and does also cause sores and ulcers in the mouth.

Prof Philippe Guérin, director of the Infectious Diseases Data Observatory at the University of Oxford, agreed that the study “is a valuable starting point and should help increase interest from both the research community and funders”.