A systematic scoping review of knowledge, attitude, perception, and public health burden of Noma Disease in Nigeria

Abstract Noma is a rapidly progressive orofacial gangrene associated with extreme poverty, malnutrition, and limited access to healthcare, with Nigeria accounting for a substantial proportion of global cases. Despite its severity and recognition as a neglected tropical disease by the World Health Organization, evidence regarding its public health burden, knowledge, perceptions, and healthcare responses in Nigeria remains fragmented. This scoping review aimed to map and synthesise existing evidence on knowledge, attitudes, perceptions, and the public health burden of Noma disease in Nigeria. A systematic scoping review followed Arksey and O’Malley’s framework, enhanced by Joanna Briggs Institute guidance and reported PRISMA-ScR. PubMed, Scopus, Web of Science, CINAHL, African Journals Online, and Google Scholar were searched for peer-reviewed studies published between 2020 and 2026. Data were extracted using a form and synthesised thematically. Fourteen studies met the inclusion criteria. Healthcare workers demonstrated variable awareness but inadequate clinical knowledge for early recognition and management in primary care. A persistent gap between knowledge and practice reflected deficiencies in training and referral systems. Cultural beliefs and reliance on traditional healers frequently delayed biomedical care, although structured engagement of healers may improve early referral. Epidemiological evidence showed a high burden in northwestern Nigeria, driven by poverty, malnutrition, and infectious diseases. Stigma, social exclusion, and mental health challenges among survivors were consistently reported but insufficiently addressed. Noma remains an important public health challenge in Nigeria, reflecting persistent health inequities and gaps in prevention, early detection, and survivor support. Strengthening surveillance, healthcare workforce capacity, community engagement, and integrated care approaches, alongside further multicentre research, is needed to inform sustainable Noma prevention and control strategies.