Mycetoma in children in sudan transactions of the royal. Mycoses of the sudan transactions of the royal society of. She lives in the village of shadida agabna, in gezira state, a region south of khartoum, sudan that is heavily affected by mycetoma. Khartoum,sudan ahmedfahal1,elsheikhmahgoub1,ahmedm. Author summary many researchers consider the sudan as the mycetoma homeland. The causative organisms of mycetoma are distributed worldwide but are endemic in tropical and subtropical areas in the mycetoma belt, which includes the bolivarian republic of venezuela, chad, ethiopia, india, mauritania, mexico, senegal, somalia, sudan and yemen. It has many medical, social and economic impacts both on patients and the community. Mycetoma initiative in sudan sudanese american medical.
Mycetoma is a chronic, specific, granulomatous, progressive subcutaneous inflammatory disease. In general, actinomycetoma is more often seen in subtropical areas. Gezira state was recognized as having one of the highest incidences of mycetoma. The disease is characterised by extensive subcutaneous masses, usually with sinuses draining pus, blood, and fungal grains. Mycetoma is a chronic, progressively destructive morbid inflammatory disease usually of the foot but any part of the body can be affected. In addition, it is reported from different parts of the world 1,2. They have rich track records in patients management, teaching, research and community development. In addition, cultureindependent dnamediated typing tests need to be developed for this organism, since m. Infection is most probably acquired by traumatic inoculation of certain fungi or. The firstever doubleblind, randomized clinical trial for an effective treatment for the severely neglected disease mycetoma has enrolled its first patient at. Asia, india, the yemen, and pakistan have the highest incidence. The mycetoma research center was established in 1991 under the umbrella of the university of khartoum.
The disease affects individuals of all ages, although disability is most severe in adults who work outdoors. Madurella mycetomatis eumycetoma was the most common type 70%. Mycetoma is a unique neglected tropical disease caused by a substantial number of microorganisms of fungal or bacterial origins. The mycetoma research centre, university of khartoum, khartoum 11111, sudan. Madurella mycetomatis eumycetoma was the most common. Clinical trial for a better treatment for mycetoma starts. Fungal mycetoma eumycetoma is the most common type in africa, while bacterial mycetoma actinomycetoma causes most cases in south and central america and some asian countries. However, there is no recent report on mycetoma in the country. It was set up at soba university hospital to provide medical care for mycetoma patients, research and education and teaching in the various aspects of mycetoma mycetoma is a common health problem, endemic in many tropical and subtropical regions and reported throughout the globe. We included all patients diagnosed with eumycetoma who underwent a surgical operation in the center during january 20. Transactions of the royal society of tropical medicine and hygiene. Mycetoma can also be found in natives of areas of central and south america and the middle or far east between latitudes 15s and 30n. The mycetoma holistic management 2018 brighton and sussex.
A new model for management of mycetoma in the sudan, plos neglected tropical diseases, 2014, volume 8, issue 10. We report on 722 children with confirmed mycetoma seen at the mycetoma research centre, khartoum, sudan during may 1991 to march 2009. Mycoses in the sudan are still significant and, as well as mycetoma, there are a number of other fungal diseases. Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. Khartoum, sudan 19 june 2017 first ever doubleblind study for disease so neglected that it only recently was added to who list of neglected tropical diseases the firstever doubleblind, randomized clinical trial for an effective treatment for the severely neglected disease mycetoma has enrolled its first patient at the mycetoma research centre mrc in khartoum, sudan.
In 1977 mahgoub published data on mycetoma in sudan, but no more data were published until the mrc was established. Madurella mycetomatis strains from mycetoma lesions in. May 26, 2018 in eumycetoma, a comparative doubleblind randomized study with itraconazole and fosravuconazole along with surgical treatment is being carried out at the mycetoma research center in khartoum, sudan. It is endemic in what is known as the mycetoma belt, which includes sudan, somalia, senegal, india, yemen, mexico, venezuela, columbia, argentina and others. Pdf madurella mycetomatis strains from mycetoma lesions in. The staff members are of medical, health and science backgrounds who are interested in all facets related to mycetoma. Mycetoma is endemic in tropical and subtropical regions of the world, predominating between latitudes 15s and 30n.
Patients with mycetoma usually present late with advanced disease, which is attributed to lack of medical and health facilities in endemic areas. Although the global disease burden is not known, mycetoma is endemic in many countries in the tropics and subtropics although most cases are reported from sudan, mexico, and india. I brought the wrong shoes, but khartoum seems to like all this water. It has a worldwide distribution but is endemic in tropical and subtropical countries across the mycetoma belt. Tropical eumycetoma is frequently caused by the fungus madurella mycetomatis. Clinical awareness about mycetoma among physicians will allow a prompt diagnosis and treatment. Mycetoma from negligence to the who neglected tropical diseases list. The first reference to mycetoma dates from the byzantine period 300600 a. It follows implantation of infectious organisms, either fungi eumycetomas. In eumycetoma, a comparative doubleblind randomized study with itraconazole and fosravuconazole along with surgical treatment is being carried out at the mycetoma research center in khartoum, sudan. The patients were predominately young 64% under 30 years old males 76%. Mycetoma is more frequent in the socalled mycetoma belt latitude 15 south and 30 north around the tropic of cancer, especially in sudan, nigeria, somalia, india, mexico, and venezuela. In africa, mycetoma predominates in sudan, somalia, mauritania, senegal, and their neighboring countries.
Diagnosis is based on clinical manifestations, including swelling and deformity of affected areas, as well as the presence of granulation tissue, scars, abscesses, sinus tracts, and a purulent exudate that contains the microorganisms. The data tentatively imply that different manifestations of mycetoma are due to differences in host susceptibility rather than differential virulence of the causative agent. Pdf this communication reports on the mycetoma research centre of the university of khartoum, sudan experience on 6792 patients seen. This communication reports on the mycetoma research centre of the university of khartoum, sudan experience on 6,792 patients seen during the period 19912014. The countries with the highest incidence of the disease are sudan,enezuela, v mexico, and india, 11but sudan and mexico have the highest number of cases reported. Mycetoma is an infectious disease often seen in tropical and subtropical regions such as in the african continent, and since there is a lack of basic information on the disease including its transmission pathway and incidence, it is said to beone of the most neglected tropical diseases. Mycetoma, chromoblastomycosis and other deep mycoses mycetoma. The majority 68% were from the sudan mycetoma belt and 28% were students. Mycetoma is a health problem in equatorial regions of africa, latin america, and asia known as the mycetoma belt.
Mycetoma initiative in sudan mycetoma is a morbid, destructive disfiguring chronic inflammatory disease with many adverse impacts on patients, communities and health authorities. Mrc was established in 1991 under the umbrella of the university of khartoum. Mycetoma is a mutilating, chronic, granulomatous infection of the subcutaneous tissue, which will ultimately affect deep structures and bone. Pdf madurella mycetomatis strains from mycetoma lesions. This infection results in a granulomatous inflammatory response in the deep dermis and subcutaneous tissue, which can extend to the underlying bone. A causative organism, such as an infectious fungal spore, will enter the body through an open wound or abrasion and works its way through skin and tissue until it. Pdf geospatial distribution of mycetoma in sudan find, read and cite all the research you need on researchgate.
Mycetoma is a major health problem in many tropical and subtropical regions. It is commoner in males, especially those in their third or fourth decade who work on the land. Compared with major diseases such as tuberculosis, malaria, and hiv, disease from m. The mycetoma research center, khartoum, sudan youtube.
Mycetoma presents as a chronic, relatively painless, subcu. Department of surgery, faculty of medicine, university of. Jan 02, 2015 it occurs in what has been described as the mycetoma belt between the latitudes of 15 south and 30 north and is endemic in arid areas. According to the mycetoma research centre, in khartoum about 2025% of mycetoma patients are children. It is interesting to note that most of the reported mycetoma data are from hospitalbased studies and from patients. They often drop out of school and are unable to remain among their peers. Mycetoma belt arid regions, short rainy season, little temperature fluctuations extremely rare to have infection by more than one species in the same individual endemic countries india, sudan m.
The first report on mycetoma was at the turn of the eighteenth century, and since then many documents on mycetoma have been reported. Mapping the potential risk of mycetoma infection in sudan and south sudan using ecological niche modeling abdallah m. The model consisted of a house to house survey to detect mycetoma suspected patients and to refer them for further management, kap, epidemiological and ecological studies. A new model for management of mycetoma in the sudan plos. Sep 04, 2018 mycetoma is a chronic infection, newly designated by the world health organization who as a neglected tropical disease, which is endemic in tropical and subtropical regions. Jan 09, 2017 mycetoma is endemic in africa, from sudan and somalia through mauritania and senegal. Fungal mycetoma eumycetoma is the most common type in africa, while bacterial mycetoma actinomycetoma causes most. Mycetoma socioeconomic impacts were addressed in many national newspapers in sudan, and that included articles on.
Although mycetoma is found worldwide, it is endemic in tropical oand subtropical countries, mostly between the latitudes 15 south and 30. Who mycetoma, chromoblastomycosis and other deep mycoses. Ezzan kunna, taro yamamoto, takayuki wada, ahmed fahal. Mar 27, 2015 this communication reports on the mycetoma research centre of the university of khartoum, sudan experience on 6,792 patients seen during the period 19912014. Townsend peterson1 1biodiversity institute and department of ecology and evolutionary biology, university of kansas, lawrence, kansas, united states of america, 2entomology department. The sixth international conference on mycetoma the khartoum. Mycetoma is a subcutaneous disease that can be caused by aerobic bacteria actinomycetoma or fungi eumycetoma. In 1977 mahgoub published data on mycetoma in sudan, but no more data were published until the mrc was. Clinical awareness about mycetoma among physicians will allow a. While most cases of mycetoma occur in sudan, venezuela, mexico, and india, its true prevalence and incidence are not wellknown. This communication reports on the mycetoma research centre of the university of khartoum, sudan experience on 6792 patients seen during the period. Different laboratorybased diagnostic tools and techniques were developed over.
The centre staff has continually explored new patients management approaches through clinical and basic research. Mapping the potential risk of mycetoma infection in sudan. Mycetoma is a chronic infective condition of tropical and subtropical regions. Diagnosis is based on clinical manifestations, mycetoma is a chronic infection that develops after traumatic inoculation of the skin with either true fungi or aerobic actinomycetes. Mycetoma mycetoma is a chronic subcutaneous infection caused by actinomycetes or fungi. Mycetoma is a unique and troubling neglected tropical disease, endemic in many tropical and subtropical areas. Mycetoma may be caused by true fungi or by higher bacteria and hence it is classified as eumycetoma and actinomycetoma respectively. It was set up at soba university hospital to provide medical care for mycetoma patients, research and education and teaching in the various aspects of mycetoma. Identification of the causative organism and the disease extension are the first steps in the management of the affected patients and predicting disease treatment outcome and prognosis. Mycetoma is a chronic subcutaneous infection caused by aerobic actinomycetic bacteria actinomycetoma or fungi eumycetoma. It was hotter last time, and less wet, the rainy season is just arriving.
Zijlstra4 1mycetoma research centre, university of khartoum, khartoum, sudan, 2faculty of mathematical sciences, university of khartoum, khartoum, sudan, 3faculty of. It is a chronic granulomatous subcutaneous inflammatory disease that has a profound and negative impact on numerous medical, healthrelated and socioeconomic aspects of the lives of patients and. Azrag rs, bakhiet sm, almalik am, mohamed ah, fahal ah. Jan 14, 2019 in this study, we share our experience of different operative techniques undertaken on 584 eumycetoma patients in the gezira mycetoma center.
The directorgeneral of the world health organization, dr tedros adhanom ghebreyesus, on sunday 24 october 2018 had visited the mycetoma research centre in khartoum sudan, who collaborating centre on mycetoma where he pledged to support initiatives that. Molecular diversity among clinical isolates of madurella mycetomatis, the prime fungal agent of human mycetoma in sudan, could possibly explain the diverse clinical presentations of this severely debilitating infectious disease. The true incidence and prevalence of mycetoma worldwide is not precisely known 5,6,7,8. Mycetoma is a serious health problem in many tropical and subtopical subcontinents. A new model for management of mycetoma in the sudan pdf. The clinical triad of subcutaneous nodule, sinuses and discharge usually. Mapping the potential risk of mycetoma infection in sudan and. In sudan, mycetoma is common in gadarif, kassala, sinnar, gezira, khartoum, kordofan, and darfur states. This runs from india to yemen and goes through sudan, senegal, and onto south america and mexico. Elhassan1,manarelsheikhabdelrahman2 1 mycetomaresearchcentre,universityofkhartoum, khartoum,sudan,2 facultyofmathematical. Mycetoma has a worldwide distribution but that is extremely uneven.
Thestudy included 6,792patients with confirmed mycetoma. Pdf geospatial distribution of mycetoma in sudan researchgate. Little reservoirs are expanding from every crack in the road and green things are sprouting at the mycetoma research centre mrc. Sudan, mycetoma is common in gadarif, kassala, sinnar, gezira, khartoum, kordofan, and darfur states. The incrimination of ticks on transmission of madurella mycetomatis in a mycetoma endemic village in sudan. A new model for management of mycetoma in the sudan. Mycetoma is a neglected tropical disease, characterized by disabling deformities and associated with severe morbidity and increased mortality. Author summary the mycetoma research centre mrc in sudan adopted an integrated village management model in an attempt to encourage patients to present early for treatment.
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