Mycetoma in West Africa

Abstract

Background Mycetoma is a neglected disease, which is socioeconomically important, and with the possibility of permanent disability in infected persons if not treated early. This is especially true in resource-limited settings such as West Africa, where there is a lack of facilities and skilled personnel to make a definitive laboratory diagnosis. Countries in West Africa have similar climatic conditions to Sudan. The majority of patients seek medical care very late, when there is already bone involvement, resulting in amputations. This results in poor capture of the true burden of the problem in the literature. Methods A review of the literature revealed about 2685 documented cases in West Africa from 1929 to 2020; from 15 out of 16 countries, Senegal accounted for 74.1% (1943) of cases in the subregion. Results The majority of lesions were found on the foot; however, other body parts were also reported. Rural dwellers accounted for most cases. Only 547 (20.4%) cases had identified isolates reported. Actinomycetoma accounted for 47.9% of cases, eumycetoma 39.7% and unidentified pathogens 12.4%. Actinomadura pelletieri was the predominant pathogen isolated (21.4%; 117 isolates). Conclusion There is a dire need for capacity building, provision of facility and health education to raise awareness of this debilitating disease in West Africa.

The Mycetoma Research Centre experience during the COVID-19 pandemic: obstacles and beyond

“…Sudan has the highest disease burden. 3 , 4 Mycetoma is a chronic granulomatous inflammatory disease caused by more than 70 microorganisms of bacterial and fungal origins. It is characterised by painless subcutaneous masses that gradually increase in size, eventually developing multiple sinuses, which produce a purulent and seropurulent discharge that contains grains of different colours, sizes and consistency.…”

“…The MRC has two outreach mycetoma units to provide care and support for patients in endemic regions. 3 To engage the community in disease prevention and control, the MRC approached different civil society groups in both Sudan and globally to raise and promote mycetoma advocacy for early case detection and management, as currently there are no reliable data upon which to base robust disease preventive and control measures.…”

Mycetoma, chromoblastomycosis and other deep fungal infections: diagnostic and treatment approach

“…Initial duration of medical treatment is recommended for 6 months followed by debulking and prolonged medical treatment, usually years [2]. Terbinafine (1 g per day) may replace itraconazole in places where it is not available, or can be used together in refractory cases [2]. Old reports of a combination of trimethoprim-sulfamethoxazole, amoxicillin-clavulanic plus itraconazole, and surgery achieved 100% cure, 91% cure rates were reported with terbinafine plus surgery [2].…”

Systematic whole-genome sequencing reveals an unexpected diversity among actinomycetoma pathogens and provides insights into their antibacterial susceptibilities

“…The inflammatory process usually spreads to affect the skin, deep tissues and bone, leading to massive destruction, deformity and disability, and can be fatal [3][4][5]. It is endemic in many countries around the equator in a zone often described as the mycetoma belt, with Sudan reported as the most affected country [6][7][8].…”