Thestudy included 6,792patients with confirmed mycetoma. Mycetoma is endemic in tropical and subtropical areas of what is coined the mycetoma belt, which includes venezuela, chad, ethiopia, india, mauritania, mexico, senegal, somalia, sudan, and yemen. The authors received no specific funding for this work. The first report on mycetoma was at the turn of the eighteenth century, and since then many documents on mycetoma have been reported. March 2009 itting in the middle of the african meningitis belt stretching from. The south sudan medical journal is a quarterly publication intended for healthcare professionals, both those working in the south sudan and those in other parts of the world seeking information on health in south sudan. Mapping the potential risk of mycetoma infection in sudan. Here, we map risk of mycetoma infection across sudan and south sudan using ecological niche modeling enm. May 10, 2018 a holistic approach to the mycetoma management. Mycetoma has a worldwide distribution but that is extremely uneven. A disease so neglected its not even on mostneglected. The history of mycetoma in the sudan is long and exciting. 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. The prevalence in some villages in sudan where mycetoma is.
The incrimination of ticks on transmission of madurella mycetomatis in a mycetoma endemic village in sudan. Slede and colleagues reported on 1729 hospital patients with mycetoma from different parts of sudan seen in the period 19511952. Vntr confirms the heterogeneity of madurella mycetomatis. The firstever doubleblind, randomized clinical trial for an effective treatment for the severely neglected disease mycetoma has enrolled its first patient at. Dec 12, 2012 mycetoma is a chronic, localized, slowly progressing infection of the cutaneous and subcutaneous tissues caused either by fungi eumycetoma or implantation mycosis or by aerobic actinomycetes actinomycetoma. 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.
Mycetoma is a chronic infection mainly of the foot that may spread to other parts of the body and causes severe deformity. When going back to the report done by national health information centre of the fmoh,all reported cases are located in khartoum, this is not true but may. Clinical trial for a better treatment for mycetoma starts in. Mexico 2607 cases, sudan 2555 cases and india 92 cases. Poverty the level of poverty in the sudan remains alarming, despite a downward trend, with 46. Azrag rs, bakhiet sm, almalik am, mohamed ah, fahal ah. The true incidence and prevalence of mycetoma worldwide is not precisely known 5,6,7,8. It was first described in india by gill in 1842 and the term mycetoma was first used by carter in 1860 1, 2.
However, when the value is discounted for inequality, the hdi falls to 0. This disease, which usually affected the feet of barefoot native. Mycetoma initiative in sudan sudanese american medical. Addressing the burden of mycetoma draft resolution proposed by egypt, nigeria and sudan the executive board, having considered the report on mycetoma,1 recommends to the sixtyninth world health assembly the adoption of the following resolution. Diversity and geographic distribution of soil streptomycetes. The majority 68% were from the sudan mycetoma belt and 28% were students. Elhassan1,manarelsheikhabdelrahman2 1 mycetomaresearchcentre,universityofkhartoum, khartoum,sudan,2 facultyofmathematical. In 66% of the patients the duration of the disease was less than five years, and 81% gave a history of sinuses discharging mostly black grains 78%. Directorgeneral of who calls for more mycetoma research during visit to mycetoma research centre 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.
Environmental occurrence of madurella mycetomatis, the major. Free fulltext pdf articles from hundreds of disciplines, all in one place. Mycetoma is a mutilating, chronic, granulomatous infection of the subcutaneous tissue, which will ultimately affect deep structures and bone. A new model for management of mycetoma in the sudan pdf. Mycoses in the sudan are still significant and, as well as mycetoma, there are a number of other fungal diseases. It was hotter last time, and less wet, the rainy season is just arriving. 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. Pdf this communication reports on the mycetoma research centre of the university of. History of trauma at the mycetoma site was reported in 20%. Mycetoma research centre mrc university of khartoum faculty of medicine.
In an attempt to prevent sanctions from negatively impacting regions in sudan under assault by. Clinical trial for a better treatment for mycetoma starts. The map shows soil collection sites black spots, the mycetoma prevalence belt thick broken red line according to 27 and the confirmed streptomyces sudanensis areas inverted red triangles from 9. Mycetoma is a chronic granulomatous inflammatory and infectious disease that affects various body parts, mainly the limbs. People of low socioeconomic status who walk barefoot and manual workers. This was followed by farmers 1,239 18% and manual domestic. The mycetoma research centre mrc in sudan adopted an integrated village management model in an attempt to encourage patients to present early for treatment. From the hospitals records, abbot in 1956 reported 1231 patients seen over a period of 30 months. Tropical eumycetoma is frequently caused by the fungus madurella mycetomatis.
Links to pubmed are also available for selected references. A new model for management of mycetoma in the sudan. The red bars indicate the boundaries of the sudanese mycetoma belt. Little reservoirs are expanding from every crack in the road and green things are sprouting at the mycetoma research centre mrc. Mahgoub from the mycetoma clinic at khartoum north and the ministry of health records, reported an incidence of 365 new patients annually seen in the period between 19711975 32. 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. It is interesting to note that most of the reported mycetoma data are from hospitalbased studies and from patients. A new species of nonsporulating fungus, isolated in a case of blackgrain mycetoma in sudan, is described as madurella fahalii. 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.
Get a printable copy pdf file of the complete article 3. From central sudan, moghraby reported on 817 mycetoma patients seen at wad madani civil hospital, central sudan, in a period of 11 years. The mrc in collaboration with sennar state ministry of health, sudan had established a region mycetoma centre in one of the endemic mycetoma villages in the state. Mapping the potential risk of mycetoma infection in sudan and south sudan using ecological niche modeling abdallah m. It is a chronic granulomatous inflammatory disease caused by several true fungi or certain actinomycetes, and hence it is classified as eumycetoma and actinomycetoma. Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. The characteristic mri findings can help make an early noninvasive diagnosis of cranial eumycetoma ce, and allow. Coronal mri t1w image post contrast shows mycetoma on the rt side of the brain. At the clinic, doctors prescribed ketoconazole to treat alhassan.
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. Mycetoma from negligence to the who neglected tropical diseases list. The centre staff has continually explored new patients management approaches through clinical and basic research. The mycetoma village for sudan cultural heritage duration.
Mar 27, 2015 the majority 68% were from the sudan mycetoma belt and 28% were students. Vntr confirms the heterogeneity of madurella mycetomatis and. All relevant data are within the paper and its supporting information files. The mycetoma research center, khartoum, sudan youtube. The disease is characterised by extensive subcutaneous masses, usually with sinuses draining pus, blood, and fungal grains. Mycetoma is a major health problem in many tropical and subtropical regions. The staff members are of medical, health and science backgrounds who are interested in all facets related to mycetoma.
It is acquired by traumatic implantation, most commonly in the tropics and subtropics, especially in rural agricultural communities. The sixth international conference on mycetoma professor ahmed mohamed suleiman duration. Mycetoma is a chronic subcutaneous infection caused by aerobic actinomycetic bacteria actinomycetoma or fungi eumycetoma. Pdf a new model for management of mycetoma in the sudan. Mycetoma initiative in sudan mycetoma is a morbid, destructive disfiguring chronic inflammatory disease with many adverse impacts on patients, communities and health authorities. Pdf patients with mycetoma usually present late with advanced disease, which is attributed to lack of medical and health facilities in endemic areas. The lesion is usually on the foot but all parts of the body can be affected. The disease affects individuals of all ages, although disability is most severe in adults who work outdoors. In general, actinomycetoma is more often seen in subtropical areas. While most cases of mycetoma occur in sudan, venezuela, mexico, and india. Mapping the potential risk of mycetoma infection in sudan and south sudan using ecological niche modeling. In an attempt to prevent sanctions from negatively impacting regions in sudan under assault by the government, the sanctions have.
Townsend peterson1 1biodiversity institute and department of ecology and evolutionary biology, university of kansas, lawrence, kansas, united states of america, 2entomology department. Although well recognized elsewhere in asia, it has. Sudan is a mycetoma highly endemic country with the highest reported prevalence, and. 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. However, there is no recent report on mycetoma in the country. Mycetoma can be caused by bacteria actinomycetoma or fungi eumycetoma and typically affects poor communities in remote areas. The journal is published in midfebruary, may, august and november.
Since the mycetoma research centers clinic opened in khartoum in 1991, 7,210 people have been diagnosed there. A new model for management of mycetoma in the sudan plos. Elhassan1,manarelsheikhabdelrahman2 1 mycetomaresearchcentre,universityofkhartoum, khartoum, sudan,2 facultyofmathematical. They have rich track records in patients management, teaching, research and community development. Ezzan kunna, taro yamamoto, takayuki wada, ahmed fahal. Mapping the potential risk of mycetoma infection in sudan and. Mycetoma is a chronic granulomatous progressive inflammatory disease, that involve the subcutaneous tissue after a traumatic inoculation of the causative organism. Sudan popular defense forces pdf the popular defense force, the military wing of the national islamic front, consists of 10,000 active members, with 85,000 reserves as of 2004. The average loss due to inequality for low hdi countries is 31.
The early history of mycetoma has been outlined by hirsch 1886, chalmers and archibald 1916 and boyd and crutchfield 1921. Author summary the mycetoma research centre mrc in sudan. The causative microorganisms probably enter the body by a thorn prick. Jun 19, 2017 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. Khartoum,sudan ahmedfahal1,elsheikhmahgoub1,ahmedm. Enms calibrated in endemic districts were transferred across sudan, and suggested that greatest risk was in a belt across central sudan. The main causative agent of eumycetoma in sudan is madurella mycetomatis 4, 15. I brought the wrong shoes, but khartoum seems to like all this water. Sudans constitution of 2005 subsequently amended historical. In 1977 mahgoub published data on mycetoma in sudan, but no more data were published until the mrc was established. May 23, 2016 mycetoma is endemic in tropical and subtropical areas of what is coined the mycetoma belt, which includes venezuela, chad, ethiopia, india, mauritania, mexico, senegal, somalia, sudan, and yemen.
Khartoum, sudan ahmedfahal1,elsheikhmahgoub1,ahmedm. New species of madurella, causative agents of blackgrain. It is an infection of subcutaneous tissues resulting in mass and sinus formation and a discharge that contains grains. 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.
Previous work suggested a soilborne or acacia thornprickmediated origin of mycetoma infections, but no studies have investigated effects of soil type and acacia geographic distribution on mycetoma case distributions. Author summary many researchers consider the sudan as the mycetoma homeland. Madurella mycetomatis eumycetoma was the most common type 70%. This communication reports on the mycetoma research centre of the university of khartoum, sudan experience on 6792 patients seen during the period. Although mycetoma is found worldwide, it is endemic in tropical oand subtropical countries, mostly between the latitudes 15 south and 30. Pdf geospatial distribution of mycetoma in sudan find, read and cite all the research you need on researchgate. The term mycetoma was introduced by vandyke carter 1860 for a disease which gill 1842 had recognized as a clinical entity while working at the madura dispensary in southern india. In this communication, the mycetoma research center mrc, sudan shares its experience in implementing a new holistic approach to manage mycetoma patients locally at the village level. Mycetoma is a common neglected tropical disease, reported worldwide but endemic in many tropical and subtropical regions in what is known as the mycetoma belt and sudan seems to have the highest endemicity 1, 2. Sudan is without doubt the epicenter of the disease. In this study we set out to determine the predictors of cure, amputation and followup dropout among a group of patients with mycetoma seen at the mycetoma research center mrc, university of khartoum, khartoum, sudan. The population of the sudan is estimated at just over 40 million, 41 per cent of whom are under 15 years of age, 56 per cent between 15 and 64 years, and 3 per cent over 65.