Knowledge, attitudes and practices of healthcare workers towards noma in Zambezia, Mozambique.

BACKGROUND: Noma is a neglected tropical disease primarily affecting children living in poverty. Despite being preventable and treatable with readily accessible medicines, an estimated 90% of patients die due to lack of access to prompt and appropriate care. METHODOLOGY AND PRINCIPAL FINDINGS: Primary, secondary and quaternary health facilities were visited on a convenience-sampling basis in Zambezia Province, central Mozambique. Health professionals were invited to participate on a quota-sampling basis, and were administered a questionnaire including open and close-ended questions assessing their oral health practices, theoretical knowledge on noma and attitudes towards receiving a noma training. A total of 41 health professionals from 23 different health facilities participated in the study. Of these, 59% were aware of noma, and 26.8% reported having personally attended to an acute noma patient. However, their knowledge of noma's clinical characteristics and management was poor, especially in its early stages. Only 12% correctly diagnosed noma at stage 1, and 5% at stage 2. University-level professionals had a significantly better understanding of the disease than nurses and technicians. All participants were keen on receiving specific noma training. CONCLUSIONS: Noma management competencies in Zambezia are extremely low, particularly among nurses and medical technicians, who serve as the first point of care for noma patients. There is an urgent need to implement comprehensive training programs across all levels of Mozambican healthcare providers, to prevent further avoidable deaths and reduce the severe outcomes associated with delayed treatment.