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BackgroundMycetoma is a chronic mutilating disease of the skin and the underlying tissues caused by fungi or bacteria. Although recently included in the list of neglected tropical diseases by the World Health Organization, strategic control and preventive measures are yet to be outlined. Thus, it continues to pose huge public health threat in many tropical and sub-tropical countries. If not detected and managed early, it results into gruesome deformity of the limbs. Its low report and lack of familiarity may predispose patients to misdiagnosis and delayed treatment initiation. More so in situation where diagnostic tools are limited or unavailable, little or no option is left but to clinically diagnose these patients. Therefore, an overview of clinical course of mycetoma, a suggested diagnostic algorithm and proposed use of materials that cover the exposed susceptible parts of the body during labour may assist in the prevention and improvement of its management. Furthermore, early reporting which should be encouraged through formal and informal education and sensitization is strongly suggested.Main textAn overview of the clinical presentation of mycetoma in the early and late phases, clues to distinguish eumycetoma from actinomycetoma in the field and the laboratory, differential diagnosis and a suggested diagnostic algorithm that may be useful in making diagnosis amidst the differential diagnosis of mycetoma is given. Additionally, a proposed preventive measures which may be helpful in the community is also provided. Since treatment is currently based on expert opinion, we encourage active research to establish treatment guideline for it.ConclusionSince delay in visiting health facility results into gruesome complication, early presentation, recognition and initiation of appropriate choice of regimen is helpful in reducing complications. The clinical overview of mycetoma and the suggested algorithm may enhance suspicion and possibly increase recognition of mycetoma in the community and further guide in differentiation of eumycetoma from actinomycetoma. There is an urgent need for research funding for mycetoma, a disease plagued by severe physical disabilities and social stigma leading to isolation.Electronic supplementary materialThe online version of this article (10.1186/s12941-018-0287-4) contains supplementary material, which is available to authorized users.

Nomads in Nigeria have high TB rates, and active case-finding approaches may be useful in identifying and successfully treating them. Large-scale interventions in vulnerable populations can improve TB case detection.

role in scientific inference might seem problematic. Scientific research contributes to what Kitcher calls "public knowledge", "that body of shared information on which people draw in pursuing their own ends" (Kitcher, 2011, p.85). Given that different people hold different values, a value-laden science may fail to contribute to "public" knowledge. I think this is a serious concern, which outweighs the considerations in favour of a value-laden science.Therefore, in § §2 and 3, draw on an unusual combination of Kant and Richard Jeffrey to argue that scientific inference aimed at public communication should not take account of non-epistemic concerns, thereby blunting the arguments in §1. §4 discusses how these arguments relate to scientists' broader communicative obligations, including in neonicitinoid research, and to on-going debates over inductive risk and proper scientific inference. In conclusion I outline the broader implications of my arguments for understanding the "value free ideal" for science. §1 Inductive risk and the Floating Standards Obligation In 1953, Richard Rudner claimed that the scientist qua scientist "accepts or rejects hypotheses", but no hypothesis is ever completely verified by the available evidence; therefore, decisions about acceptance must turn on whether the evidence is "sufficiently strong" (Rudner, 1953, p.2). More recently, Heather Douglas has set out a similar problem: all agents, including scientists, face choices about whether to make empirical claims which are not deductively implied by available evidence (Douglas, 2009, p.87). Both argue for a similar response to these problems. For Rudner, decisions about whether evidence is sufficiently strong are "a function of the importance, in the typically ethical sense, of making a mistake in accepting or rejecting the hypothesis" (p.2, emphasis in original). Douglas argues that everyone, including scientists, has a moral responsibility to "consider the consequences of error" (p.87) when making claims. Therefore, science is not value-free, in that "scientists should consider the potential social and ethical consequences of error in their work, they should weigh the importance of those consequences, and they should set burdens of proof accordingly" (p.87).Rudner's argument convinced many philosophers: for example, Hempel (1965) andGaa (1977). More recently, following Douglas's work, the "argument from inductive risk" has become commonplace, assumed in work by Kitcher (2011, 141-155) and Kukla (2012, 853-855) with discussions of its theoretical implications (Steel, 2010) and its practical implications (for "trust" in science (Wilholt, 2012) and model construction (Biddle and Winsberg, 2012)). Indeed, some now claim that her argument does not go far enough (Brown, forthcoming). In this paper, I will follow Rudner and Douglas in assuming that scientists face problems of "inductive risk". I will, however, dispute their claims about how scientists must respond to these problems. To understand my proposals first it is necessary to clarify...

ObjectiveWe assessed the impact of political conflict (Boko Haram) on tuberculosis (TB) case notifications in Adamawa State in North-east Nigeria.DesignA retrospective analysis of TB case notifications from TB registers (2010–2016) to describe changes in TB notification, sex and age ratios by the degree of conflict by local government area.SettingAdamawa State.Participants21 076 TB cases notified.Results21 076 cases (62% male) were notified between 2010 and 2016, of which 19 604 (93%) were new TB cases. Areas affected by conflict in 2014 and 2015 had decreased case notification while neighbouring areas reported increased case notifications. The male to female ratio of TB cases changed in areas in conflict with more female cases being notified. The young and elderly (1–14 and >65 years old) had low notifications in all areas, with a small increase in case notifications during the years of conflict.ConclusionTB case notifications decreased in conflict areas and increased in areas without conflict. More males were notified during peace times and more female cases were reported from areas in conflict. Young and elderly populations had decreased case notifications but experienced a slight increase during the conflict years. These changes are likely to reflect population displacement and a dissimilar effect of conflict on the accessibility of services. TB services in conflict areas deserve further study to identify resilient approaches that could reach affected populations.