Eumycetoma is a progressive and destructive chronic granulomatous subcutaneous inflammatory disease caused by certain fungi, the most common being Madurella mycetomatis. The host defence mechanisms against fungi usually range from an early non-specific immune response to activation and induction of specific adaptive immune responses by the production of Th-1 and Th-2 cytokines. The aim of this study is to determine the levels of Th-1 and Th-2 cytokines in patients infected with Madurella mycetomatis, and the association between their levels and disease prognosis. This is a descriptive cross-sectional study conducted at the Mycetoma Research Centre, University of Khartoum, Sudan, where 70 patients with confirmed M. mycetomatis eumycetoma were enrolled; 35 with, and 35 without surgical excision. 70 healthy individuals from mycetoma endemic areas were selected as controls. The levels of serum cytokines were determined by cytometric bead array technique. Significantly higher levels of the Th-1 cytokines (IFN-γ, TNF-α, IL-1β and IL-2) were recorded in patients treated with surgical excision, compared to those treated without surgical excision. In contrast, the Th-2 cytokines (IL-4, IL-5, IL-6 and IL-10) were significantly lower in patients treated with surgical excision compared to those treated without surgical excision. In conclusion, the results of this study suggest that cell-mediated immunity can have a role to play in the pathogenesis of eumycetoma.

Health determinants are factors that can influence our health either positively or negatively. This paper determined the factors that affect the health of Almajiri in their system of study in Gwadabawa local government of Sokoto state, Nigeria. Interview and visual observation were used to collect data, which was analyzed by thematic networks method. The result of this study was shown. Most (50.0%) of the Almajiri live in buildings own by school,whereas, 33.5% of them in donated buildings .There were three types of houses / classes where Almajiri live.Most (50.0%) were made of cement/modern style ,then (33.3%) the mud houses / classes, and (16.7%) were the ones from zinc .There were toilets for urination only ,no one was slated for defecation . In 75% of the schools there was no water, whereas 33.3% have water source from unprotected wells. In 33.3 % of the schools there was refuse dumps .In 33.3% there were no any source of risk. Whereas, in 16.7% there were gutters, and in 16.7% there were roads nearby. Personal hygiene was observed. 75.0% of Almajiri wore dirty garments.25.0% wore cleaned garments, 12.5% wore torn garments, and 87.5% wore untorn garments. 62.5% wore shoes and 37.5% have no shoes. 62.5% take bath weekly, 37.7% take bath daily. Interms of livelihood, most of them relied on begging for food; 25.0% do domestic work to get food and other needs. 70.0% of them eat twice in a day, 25.0% thrice, whereas, 5.0% once; in most cases. The result revealed many health determinants which can negatively affect the health of Almajiri.

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