Microbiological investigation into the causative agents of Noma

Noma is an infection of the oral cavity which causes the disintegration of the cheek and in some cases the nose and eye in under a week. If untreated, noma has a reported 90% mortality rate, and mainly affects children aged between two and five years. With timely antibiotic treatment, wound debridement and nutritional support, morbidity and mortality from noma greatly decrease. For those who survive, noma leads to severe facial disfigurements, functionality issues and stigmatization.

The aetiology of Noma is complex and undefined. Traditional microbiological methods alone have not been able to reliably identify a single causative organism or confidently attribute the presence or absence of certain bacteria. The project plans to use high-throughput shotgun metagenomics alongside traditional culture and immunological techniques to attempt to identify/increase confidence in identifying the causative microbiological agents. 

Where does the project lie on the Translational Pathway?

T1 – Basic Research, T2 – Human/Clinical Research

Expected Outputs

A study of this scale onto the causative agents of, and the immunological implications resulting from, noma is unprecedented. The outputs will be central to future efforts in understanding the disease and will hopefully inform treatment, diagnosis and prevention.


As such, we expect career enhancing opportunities for the student, including high-impact publications and talks at international conferences.

Training Opportunities

Full training in bioinformatic analysis of large metagenome data sets will be provided

Training in isolation of microbiological samples from complex samples will be provided

Immunological training on a range of high-throughput and sensitive techniques (e.g. Flow cytometry, FACS) will be provided.

Skills Required

We expect the student to possess strong organisational and project solving aptitude. The student would benefit from basic skills in microbiology and immunological analysis is desirable but not essential as we will provide in-depth training in all techniques.

Key Publications associated with this project

Srour ML, Marck K, Baratti-Mayer D. Noma: Overview of a Neglected Disease and Human Rights Violation. Am J Trop Med Hyg. 2017 Feb 8;96(2):268-274. doi: 10.4269/ajtmh.16-0718. Epub 2017 Jan 16. PMID: 28093536; PMCID: PMC5303022.

Srour ML, Baratti-Mayer D. Why is noma a neglected-neglected tropical disease? PLoS Negl Trop Dis. 2020 Aug 20;14(8):e0008435. doi: 10.1371/journal.pntd.0008435. PMID: 32817617; PMCID: PMC7444552.

Shaw L, Ribeiro ALR, Levine AP, Pontikos N, Balloux F, Segal AW, Roberts AP, Smith AM. The Human Salivary Microbiome Is Shaped by Shared Environment Rather than Genetics: Evidence from a Large Family of Closely Related Individuals. mBio. 2017 Sep 12;8(5):e01237-17. doi: 10.1128/mBio.01237-17. PMID: 28900019; PMCID: PMC5596345.

Rickart AJ, Rodgers W, Mizen K, Merrick G, Wilson P, Nishikawa H, Dunaway DJ. Facing Africa: Describing Noma in Ethiopia. Am J Trop Med Hyg. 2020 Aug;103(2):613-618. doi: 10.4269/ajtmh.20-0019. Epub 2020 Apr 30. PMID: 32372746; PMCID: PMC7410419.

Farley E, Oyemakinde MJ, Schuurmans J, Ariti C, Saleh F, Uzoigwe G, Bil K, Oluyide B, Fotso A, Amirtharajah M, Vyncke J, Brechard R, Adetunji AS, Ritmeijer K, van der Kam S, Baratti-Mayer D, Mehta U, Isah S, Ihekweazu C, Lenglet A. The prevalence of noma in northwest Nigeria. BMJ Glob Health. 2020 Apr 14;5(4):e002141. doi: 10.1136/bmjgh-2019-002141. PMID: 32377404; PMCID: PMC7199707.

Now Accepting Applications 

CLOSING DATE FOR APPLICATIONS: Application Portal closes: Wednesday 9th February 2022 (12:00 noon UK time)

Shortlisting complete by: End Feb/early March 2022

Interviews by: Late March/early April 2022

For more information on Eligibility, funding and how to apply please visit the MRC DTP/CASE pages