{"_asset":{"@search.score":5.8314614,"Name":"Defining the noma research agenda","AlternateTitleCommaDelimited":"","Id":"9224","AssetLocationUri":null,"Abstract":"

A 1-day symposium brought together over 100 individuals with lived experience of noma, expertise in neglected tropical diseases, and public health, including researchers, health advocates, and clinicians. The involvement of noma survivors was invaluable and added an important perspective in defining the research agenda.
The most pressing research needs identified were:
- Clear case definition of noma
- Early case detection and robust surveillance
- Psychosocial and economic impact of noma
- Decision support for diagnosing acute necrotizing gingivitis and associated antibiotic regimen(s) with treatment duration
- Deeper understanding of risk factors and social determinants
- Identification of effective information, education, and communication strategies
- Effectiveness of surgical services
- Testing decentralized follow-up for patients
- An important conclusion was that noma research and control activities must be integrated across sectors and disciplines, such as neglected tropical diseases, oral health, nutrition, and child health programs including immunization.

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Vinetz, Yale University \nSchool of Medicine, UNITED STATES OF \nAMERICA\n\nPublished: April 21, 2025\n\nCopyright: © 2025 Galli et al. This is an open \naccess article distributed under the terms of \nthe Creative Commons Attribution License, \nwhich permits unrestricted use, distribution, \nand reproduction in any medium, provided the \noriginal author and source are credited.\n\nFunding: The noma symposium has been \nfunded by the Swiss Tropical and Public Health \nInstitute. The event was financed, co-organized \nand hosted by the Swiss Tropical and Public \nHealth Institute. This manuscript has been \nprepared by staff of the Institute to make the \noutcomes and discussions of the event avail-\nable to the public.\n\nCompeting interests: The authors declare \nthat no competing interests exist. The authors \nalone are responsible for the views expressed \nin this publication and it does not necessarily \n\nPOLICY PLATFORM\n\nDefining the noma research agenda\nAnaïs Galli 1,2*, Marianne Comparet3, Daniel Argaw Dagne4, Denise Baratti-Mayer5, \nThi H. Cao6, Philippe J. Guérin7,8, Maria Guevara9, Manuel W. Hetzel1,2, Claire Jeantet10,11, \nEmmanuel Kabengele Mpinga12, Valter Muendane11, Mulikat Okanlawon11, Erika Placella13, \nMarta Ribes14,15, Mark Sherlock16, Jürg Utzinger1,2, Peter Steinmann1,2\n\n1 Swiss Tropical and Public Health Institute, Allschwil, Switzerland, 2 University of Basel, Basel, \nSwitzerland, 3 International Society for Neglected Tropical Diseases, London, United Kingdom, 4 World \nHealth Organization, Geneva, Switzerland, 5 Hôpitaux Universitaires de Genève, Geneva, Switzerland, \n6 Drugs for Neglected Diseases initiative (DNDi), Geneva, Switzerland, 7 Infectious Diseases Data \nObservatory (IDDO), University of Oxford, Oxford, United Kingdom, 8 Centre for Tropical Medicine and \nGlobal Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom, 9 Médecins \nSans Frontières, Geneva, Switzerland, 10 Inediz, Saint-Cyr-sur-Mer, France, 11 Elysium Noma Survivors \nAssociation, Basel, Switzerland, 12 Institute of Global Health, University of Geneva, Geneva, Switzerland, \n13 Swiss Agency for Development and Cooperation, Bern, Switzerland, 14 Barcelona Institute for Global \nHealth, Barcelona, Spain, 15 Faculty of Medicine and Health Sciences, University of Barcelona (UB), \nBarcelona, Spain, 16 Médecins Sans Frontières, Amsterdam, Netherlands \n\n* anais.galli@swisstph.ch\n\nAbstract \n\n• A 1-day symposium brought together over 100 individuals with lived experience of noma, \nexpertise in neglected tropical diseases, and public health, including researchers, health \nadvocates, and clinicians. The involvement of noma survivors was invaluable and added an \nimportant perspective in defining the research agenda.\n\n• The most pressing research needs identified were:\n\n○ Clear case definition of noma\n\n○ Early case detection and robust surveillance\n\n○ Psychosocial and economic impact of noma\n\n○ Decision support for diagnosing acute necrotizing gingivitis and associated antibiotic \nregimen(s) with treatment duration\n\n○ Deeper understanding of risk factors and social determinants\n\n○ Identification of effective information, education, and communication strategies\n\n○ Effectiveness of surgical services\n\n○ Testing decentralized follow-up for patients\n\n• An important conclusion was that noma research and control activities must be integrated \nacross sectors and disciplines, such as neglected tropical diseases, oral health, nutrition, and \nchild health programs including immunization.\n\nIntroduction\nNoma is a severely debilitating oro-facial gangrenous disease, mostly affecting children aged \n2–6 years [1]. Thus far, no specific causative agent of noma has been identified [2]. Yet, a \n\nhttp://crossmark.crossref.org/dialog/?doi=10.1371/journal.pntd.0012940&domain=pdf&date_stamp=2025-04-21\nhttps://doi.org/10.1371/journal.pntd.0012940\nhttps://doi.org/10.1371/journal.pntd.0012940\nhttp://creativecommons.org/licenses/by/4.0/\nhttps://orcid.org/0000-0002-5533-3211\nmailto:anais.galli@swisstph.ch\n\n\nPLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.0012940 April 21, 2025 2 / 8\n\nPLOS NegLected trOPicaL diSeaSeS Noma research agenda\n\nlarge variety of risk factors linked to poverty and inequity have been reported, such as chronic \nmalnutrition, having previously suffered from an infectious disease, poor oral hygiene, and no \nor very limited access to water, sanitation, and hygiene (WASH) infrastructure [3]. Noma may \ndevelop if an individual’s immune system is weakened, the oral microbiome is altered, and \nbacteria commonly present in the mouth shift to a pathogenic profile. Noma can be catego-\nrized into five stages: 1, acute necrotizing gingivitis (ANG); 2, edema; 3, gangrene; 4, scarring; \nand 5, sequelae [4] (Fig 1). Up to stage 2, noma is reversible with timely broad-spectrum \nantibiotic treatment, nutritional support, and oral hygiene. From stage 3 onward, functional \nimpairment and facial disfigurement become permanent. According to the gravity of the \nsequela, noma survivors require access to reconstructive surgery to facilitate a functional \nrestoration allowing them to drink, eat, speak, and breathe more easily and to support re- \nintegration into society by reducing stigmatization linked to the disfigurement [1]. However, \naccess to reconstructive surgery remains challenging, either not available or not affordable, in \nmost settings where noma occurs.\n\nCurrent epidemiologic data about the global incidence, mortality, and geographic distri-\nbution of noma is scarce [6]. Due to the rapid progression of the disease, which often results \nin undocumented deaths outside of health facilities, stigmatization in the community, limited \naccess to health care, and poor identification of noma by health workers, noma is not accu-\nrately reported. The mortality of untreated cases is believed to be very high, though evidence is \nscarce to ascertain figures [2]. Among patients receiving timely antibiotic treatment, mortality \nhas been reported to range between 0% and 38% (including patients with immunodeficiency) \n[3]. The most widely cited global incidence estimate of noma stems from a World Health \nOrganization (WHO) Delphi consultation dating back to 1998, suggesting 140,000 new cases \nper year [7]. The same consultation put forth a global prevalence of 770,000 people living with \nsequelae of the disease. Newer studies reporting noma prevalence or incidence vary greatly \nin their conclusions and are limited by poor study designs. The latest estimate on global \nincidence published in 2003 reported 30,000-40,000 noma cases annually [8]. Contrary to \ncommon belief, noma is not confined to the African continent, but occurs in most low- and \nmiddle-income countries and sporadic cases continue to occur worldwide [2,6].\n\nrepresent the decisions, policy, or views of \ntheir organizations\n\nFig 1. The five stages of noma (1–5), characterized in four localization types [4,5]. Figure drawn by Chloé Fournier/Inediz.\n\nhttps://doi.org/10.1371/journal.pntd.0012940.g001\n\nhttps://doi.org/10.1371/journal.pntd.0012940.g001\n\n\nPLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.0012940 April 21, 2025 3 / 8\n\nPLOS NegLected trOPicaL diSeaSeS Noma research agenda\n\nInterest in noma has increased since December 2023 when WHO officially declared it a \nneglected tropical disease (NTD) [9]. Additionally, two noma survivors, Mulikat Okanlawon \n(co-author) and Fidel Strub, were recognized internationally as two strong health advocates of \nthe impact of noma by the TIME 100 Health 2024 list [10]. In order to build on this unprece-\ndented momentum, the Swiss Tropical and Public Health Institute (Swiss TPH) and Elysium, \nNoma Survivors’ Association, joined forces and convened a 1-day symposium. The event \nbrought together more than 100 people with lived experience of the disease, donors, noma \nand NTDs experts, and other public health specialists, including researchers, health advocates, \nand clinicians with first-hand experience in the treatment and management of noma. The \naim of the symposium was two-fold. First, to review the current understanding of noma and \nto define a research agenda to generate new evidence and shape a strategy to prevent, con-\ntrol, and eliminate noma as a public health problem. Second, to reflect on how the identified \nresearch priorities fit into a broader framework of NTDs, highlighting potential synergies in \nadvocacy, research and development (R&D), prevention, control, and elimination of noma \nand other NTDs.\n\nMethods\nThe symposium “Defining the Noma Research Agenda” took place on 20 September 2024 at \nSwiss TPH in Allschwil, Switzerland, and was open to interested individuals and organiza-\ntions in a hybrid format for plenary sessions (Fig 2). During the morning, experts introduced \nnoma to the audience, including the latest clinical and epidemiologic research, while a panel \ndiscussion with noma survivors set the stage for sharing the realities of surviving noma and \nliving with its life-long consequences. In the afternoon, participants split into four thematic \nbreakout groups, accompanied by a note taker and rapporteur to (i) brainstorm; (ii) condense \nthe discussion into specific research questions; and (iii) develop concepts for research projects \n\nFig 2. Structure and content covered in the 1-day symposium Defining the Noma Research Agenda, held on 20 September 2024 at \nSwiss TPH in Allschwil, Switzerland. Created with Biorender.\n\nhttps://doi.org/10.1371/journal.pntd.0012940.g002\n\nhttps://doi.org/10.1371/journal.pntd.0012940.g002\n\n\nPLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.0012940 April 21, 2025 4 / 8\n\nPLOS NegLected trOPicaL diSeaSeS Noma research agenda\n\nor programs (e.g., setting, size, funding, and partners). The focal areas of the breakout groups \nwere:\n\n• surveillance and prevention of noma\n\n• physical and mental well-being of persons affected by noma\n\n• noma stages and reconstructive surgery\n\n• microbiologic and therapeutic aspects of noma\n\nA fifth breakout group was open to participants who were new to the topic and interested \nin receiving an in-depth introduction on current knowledge of noma. Once reunited in the \nplenary, the rapporteurs summarized the discussion outcomes, followed by reactions in the \nplenary, identification of cross-cutting themes, discussion on overall priorities, and exploring \npotential synergies to the broader group of NTDs.\n\nResults\n\nSymposium participants\nParticipants at the 1-day symposium were affiliated with academia, non-governmental organi-\nzations (NGOs), public health institutions, government and private sector, donor community, \nWHO, and product development partnerships (Fig 3). Overall, 77 people participated physi-\ncally and 30 were present online, including speakers and moderators.\n\nIdentified research needs\nDuring the four thematic sessions, the following topics were identified as most pressing:\n\n1. Clear case definition: A commonly applied standard protocol based on the WHO-defined \nnoma stages is needed to improve the accuracy and validity of data, facilitate early detec-\ntion, and ensure the quality of diagnosis and care. Standardized reporting is even more \npressing as a foundation for research and surveillance. Of note, with most noma cases \noccurring in remote rural areas away from formal health infrastructures, clear and prag-\nmatic definitions are instrumental in supporting all actors formally or informally involved \nin primary healthcare at the community level, including traditional healers.\n\nFig 3. Characteristics of noma symposium participants who have participated in-person (blue) or for online \nattendance (green).\n\nhttps://doi.org/10.1371/journal.pntd.0012940.g003\n\nhttps://doi.org/10.1371/journal.pntd.0012940.g003\n\n\nPLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.0012940 April 21, 2025 5 / 8\n\nPLOS NegLected trOPicaL diSeaSeS Noma research agenda\n\n2. Early case detection and robust surveillance: Health information and reporting systems \nadapted to remote and resource-constrained settings are critical for capturing data on \nnoma cases and affected populations, thus determining the noma disease distribution \nand burden as accurately as possible. In addition, detecting cases early and collecting \nessential data on demographic characteristics, the occurrence and clinical presentation of \nnoma patients will provide the evidence base for timely targeted prevention and response \nfocusing on areas and populations most at risk. Digital technology, such as mapping of \nhigh-risk areas, and integration with other surveillance platforms and preventive pro-\ngrams, including for other NTDs or childhood conditions, offers opportunities for syner-\ngistic management and control. A robust case detection and data collection framework is \nessential in ensuring the protection of highly sensitive data, collected in some of the most \nneglected and vulnerable areas and populations.\n\n3. Psychosocial and economic impact of noma: People affected by noma and their families \nare often faced with significant barriers complicating their reintegration into society. \nThese barriers include stigmatization, traditional beliefs, lack of schooling, difficulties \nfinding a job, and living with physical and mental trauma. Participatory research is \nneeded to determine not only the barriers but also amplify the direct input, views, and \nvoices of affected persons and their communities regarding the best interventions to \novercome these challenges. Evidence is required on the psychosocial and economic \nburden and mental health benefits of initiatives aiming to reintegrate noma survi-\nvors into society, such as mentorship programs, community initiatives, and support \ngroups.\n\n4. Decision support for diagnosing ANG and associated antibiotic regimen(s) with treatment \nduration: Evidence-based guidance is required on who is at risk of progressing from ANG \nto noma and which antibiotic drug combinations are recommended at what doses and \nlength of time, including possible regional differences [4]. This will promote prompt and \neffective treatment and follow-up, prevention of severe cases, and mitigate the risk of the \ndevelopment and spread of antimicrobial resistance.\n\n5. Risk factors and social determinants: Research to better characterize risk factors, social \ndeterminants, and inequities will aid in the understanding of the pathogenesis of noma \nand inform targeted prevention, surveillance, and early detection. The following areas have \nbeen identified as particularly relevant for in-depth studies: genetic factors, prior exposure \nto infectious diseases, immunologic signatures, behavior, WASH conditions, parity of \nmother, demographic factors (e.g., strong clustering in young age group, no family cluster-\ning, sex, and gender), and regional variation (e.g., stage duration).\n\n6. Identification of effective information, education, and communication (IEC) strategies: \nRaising awareness and promoting health among the public as well as health personnel is \nchallenging due to the general neglect of noma, the widespread ignorance regarding the \ncondition and the stigma associated with the disease. Consequently, the condition may be \nreferred to with particular terms that vary between socio-cultural groups, challenging IEC \nin endemic settings that are multi-lingual, multi-ethnic, or multi-cultural. One priority in \nthis field would be identifying communication strategies specifically targeted to popula-\ntions at risk. Additionally, there is a need for sensitization on the early stages of the disease \nand measures to prevent it with a focus on pregnant women, mothers and guardians of \nyoung children, traditional healers, and health workers in peripheral facilities. To ensure \nawareness, prompt diagnosis and treatment, representation of noma in relevant medical, \ndentistry, and nursing training curricula is also warranted.\n\n\n\nPLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.0012940 April 21, 2025 6 / 8\n\nPLOS NegLected trOPicaL diSeaSeS Noma research agenda\n\n7. Effectiveness of surgical services: Progress has been made with establishing surgical capacity \nin selected endemic countries, but the high degree of specialization of staff and equipment \nwill probably continue to require a proportion of cases to be treated either by mobile \nteams or in central locations. Establishing and evaluating a network of referral centers with \nthe prerequisite capacity is thus paramount. Such centers are ideally located in endemic \ncountries and address surgical needs beyond noma, but may also be located in high-income \ncountries. Additionally, ways to support family members accompanying noma patients \nduring the extended treatment and rehabilitation periods should be investigated.\n\n8. Testing decentralized follow-up: Mobile digital technology may offer novel approaches to \nreduce the length of stay in rehabilitation centers and thus the burden on families, and \nimprove follow-up. Digital technology may also facilitate the formation of self-help groups \nof persons with lived experience of noma, catch-up education, and other rehabilitation- \nrelated activities. Such tools may also facilitate the systematic collection of relevant data \n(see point 2).\n\nDiscussion and way forward\nMuch of the challenges that were discussed in the symposium pertain to the severe neglect of \nnoma and the affected and highly vulnerable populations. First, the five noma stages defined \nby WHO are only used sparsely by stakeholders in reporting, rendering comparability of \nnoma-related data challenging [4]. Consequently, we advise emphasizing their relevance, so \nthat a unified nomenclature is used across disciplines and communities. Second, the lack of \nknowledge about noma among clinicians, nurses, and other public health professionals is \nlimiting the feasibility of broad-based consultations, early case detection, and surveillance \nactivities. Noma diagnosis, clinical presentations, and treatment need to be integrated into \nhealth curricula and educational campaigns, with a focus on differential diagnosis and prompt \ninterventions to reduce the risk of irreversible damage and premature death. Third, the \nabsence of even basic epidemiologic data on noma is simply unacceptable. It is paramount to \nestablish active and passive surveillance on a global scale and to integrate noma into (national) \nhealth information systems and campaigns that include the most marginalized and vulnera-\nble populations. To start addressing the neglect, noma research should be pragmatic and not \nover-medicalized to strengthen early case detection, thus averting the disease’s progression to \nan irreversible stage.\n\nA major asset of the symposium was the active participation of noma survivors. Efforts \nshould be made to facilitate their permanent presence in research and advocacy as pio-\nneered for other conditions. Survivors' priorities were not always aligned with what academ-\nics thought to be necessary. Discussions concluded on the importance of considering the \nsocio-economic and mental health needs of people affected by noma and their families. Hav-\ning mentors and support from a community of like-minded peers or people with similar expe-\nriences, such as the pilot program Experts by Experience by Médecins sans Frontières, proved \nextremely valuable for survivors. Hence, associations of people with lived experience of noma \nneed to be strengthened locally and globally. A potential guide for such collaborations could \nbe the WHO guidelines for meaningful engagement of people with lived experience [11], the \nfact sheet of the Swiss Clinical Trial Organisation about patient and public involvement [12], \nor the 11 principles of the Commission for Research Partnerships with Developing Countries \n(KFPE) [13].\n\nFinally, in line with its recent addition to the WHO list of NTDs, noma should be fully \nintegrated into the NTD research, control, and elimination agenda. The integrated skin NTDs \nframework, for example, provides a promising fit for noma, and elaborates on how resources \n\n\n\nPLOS Neglected Tropical Diseases | https://doi.org/10.1371/journal.pntd.0012940 April 21, 2025 7 / 8\n\nPLOS NegLected trOPicaL diSeaSeS Noma research agenda\n\nfor diagnosis, wound care, detection and preventive campaigns, support groups, and advocacy \nwith people affected should be used [14]. Addressing NTDs together offers specific oppor-\ntunities for funding bodies and policymakers through reduced fragmentation and improved \ncost structures. While basic research will be instrumental in elucidating some of the pressing \nknowledge gaps around noma, control and care will be boosted with a step-up in operational \nresearch, and data to improve access to health care and prevention. This focus is in line with \nthe effort to achieve Universal Health Coverage and realize the Sustainable Development Goal \n3 pertaining to health. Recognized by the Human Rights Council in 2012 as “the most brutal \nface of poverty and malnutrition” [15], noma truly is an indicator for inequities.\n\nAcknowledgments\nWe are grateful for the support by the Swiss TPH communications team, the travel desk, and \nthe administrative officer for all their work during the planning of the symposium. In addi-\ntion, we thank the Noma Survivors Association, Elysium, for inspiring us to organize the \nsymposium and all of the helpers. Finally, we acknowledge all of the participants for their time \nand active participation in the symposium.\n\nThe opinions expressed in this paper are those of the authors and may not reflect those of \ntheir employing organizations. The authors alone are responsible for the views expressed in \nthis publication which does not necessarily represent the decisions, policy, or views of their \norganizations.\n\nAuthor contributions\nConceptualization: Anaïs Galli, Claire Jeantet, Jürg Utzinger, Peter Steinmann.\nFunding acquisition: Jürg Utzinger.\nInvestigation: Anaïs Galli, Marianne Comparet, Daniel Argaw Dagne, Denise Baratti-\n\nMayer, Thi H. Cao, Philippe J. Guérin, Maria Guevara, Manuel W. Hetzel, Claire Jeantet, \nEmmanuel Kabengele Mpinga, Valter Muendane, Mulikat Okanlawon, Erika Placella, \nMarta Ribes, Mark Sherlock, Jürg Utzinger, Peter Steinmann.\n\nMethodology: Anaïs Galli, Claire Jeantet, Jürg Utzinger, Peter Steinmann.\nProject administration: Anaïs Galli, Peter Steinmann.\nSupervision: Peter Steinmann.\nVisualization: Anaïs Galli.\nWriting – original draft: Anaïs Galli, Peter Steinmann.\nWriting – review & editing: Marianne Comparet, Daniel Argaw Dagne, Denise Baratti-\n\nMayer, Thi H. Cao, Philippe J. Guérin, Maria Guevara, Manuel W. Hetzel, Claire Jeantet, \nEmmanuel Kabengele Mpinga, Valter Muendane, Mulikat Okanlawon, Erika Placella, \nMarta Ribes, Mark Sherlock, Jürg Utzinger.\n\nReferences\n 1. World Health Organization [Internet]. Fact sheet Noma; 2023 [cited 2025 Jan 20]. Available from: \n\nhttps://www.who.int/news-room/fact-sheets/detail/noma\n\n 2. Maguire B, Shrestha R, Dahal P, Ngu R, Nizigama L, Rashan S, et al. 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Available from: https://kfpe.scnat.ch/en/11_principles_7_questions/uuid/i/13beb0f7-4780-5967-\na257-bd6cc3d5e424-A_Guide_for_Transboundary_Research_Partnerships_3rd_edition_-_2018\n\n 14. Yotsu RR. Integrated management of Skin NTDs - lessons learned from existing practice and field \nresearch. Trop Med Infect Dis. 2018;3(4):120. https://doi.org/10.3390/tropicalmed3040120 PMID: \n30441754\n\n 15. UN Human Rights Council. Study of the human rights council advisory committee on severe malnu-\ntrition and childhood diseases with children affected by noma as an example. Geneva: United Nations \nGeneral Assembly; 2012. 19th Sess. Document number: A/HRC/19/73.\n\nhttps://doi.org/10.1097/00006534-199101000-00013\nhttp://www.ncbi.nlm.nih.gov/pubmed/1984284\nhttps://doi.org/10.1016/S1473-3099(21)00698-8\nhttp://www.ncbi.nlm.nih.gov/pubmed/35303478\nhttps://doi.org/10.1046/j.1365-3156.2003.01036.x\nhttp://www.ncbi.nlm.nih.gov/pubmed/12753633\nhttps://www.who.int/news/item/15-12-2023-who-officially-recognizes-noma-as-a-neglected-tropical-disease\nhttps://www.who.int/news/item/15-12-2023-who-officially-recognizes-noma-as-a-neglected-tropical-disease\nhttps://time.com/6967236/okanlawon-strub/\nhttps://www.snf.ch/api/media/en/o5yqCe4GPIVk2RUG/scto-factsheet-ppi-en.pdf\nhttps://www.snf.ch/api/media/en/o5yqCe4GPIVk2RUG/scto-factsheet-ppi-en.pdf\nhttps://kfpe.scnat.ch/en/11_principles_7_questions/uuid/i/13beb0f7-4780-5967-a257-bd6cc3d5e424-A_Guide_for_Transboundary_Research_Partnerships_3rd_edition_-_2018\nhttps://kfpe.scnat.ch/en/11_principles_7_questions/uuid/i/13beb0f7-4780-5967-a257-bd6cc3d5e424-A_Guide_for_Transboundary_Research_Partnerships_3rd_edition_-_2018\nhttps://doi.org/10.3390/tropicalmed3040120\nhttp://www.ncbi.nlm.nih.gov/pubmed/30441754\n\n","UrlSlug":"defining-noma-research-agenda","collections":[],"countries":[],"asset_languages":[{"AlternateTitle":"","language":[{"Id":1,"Name":"English"}],"contentTranslation":[],"contentLocation":[]}],"creators":[{"Name":"Sherlock M","Id":19738,"ac":[{"Order":14}]},{"Name":"Baratti-Mayer D","Id":20001,"ac":[{"Order":3}]},{"Name":"Okanlawon M","Id":20283,"ac":[{"Order":11}]},{"Name":"Guevara M","Id":24629,"ac":[{"Order":6}]},{"Name":"Dagne DA","Id":30312,"ac":[{"Order":2}]},{"Name":"Utzinger J","Id":32994,"ac":[{"Order":15}]},{"Name":"Guérin PJ","Id":33650,"ac":[{"Order":5}]},{"Name":"Ribes M","Id":34474,"ac":[{"Order":13}]},{"Name":"Galli A","Id":36491,"ac":[{"Order":0}]},{"Name":"Comparet M","Id":36492,"ac":[{"Order":1}]},{"Name":"Cao TH","Id":36493,"ac":[{"Order":4}]},{"Name":"Hetzel MW","Id":36494,"ac":[{"Order":7}]},{"Name":"Jeantet C","Id":36495,"ac":[{"Order":8}]},{"Name":"Mpinga EK","Id":36496,"ac":[{"Order":9}]},{"Name":"Muendane V","Id":36497,"ac":[{"Order":10}]},{"Name":"Placella E","Id":36498,"ac":[{"Order":12}]},{"Name":"Steinmann P","Id":36499,"ac":[{"Order":16}]}],"keywords":[{"Name":"neglected tropical diseases","Id":35},{"Name":"noma","Id":47}]}}

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Defining the noma research agenda