A Comprehensive Approach for Mycetoma Management

Mycetoma is a severe infection of skin and it can also cause some chronic infection to the subcutaneous tissue. The condition was first described in the region of Madura in India where the disease was first identified. Mycetoma is also a tropical disease; it can cause severe disfigurement and disability if it is not treated early.

Mycetoma can be caused by any of 70 fungi or actinomycetes bacteria. In all cases, chronic and progressive infection and inflammation cause masses under the skin which can spread to deeper structures including bone. Sudan has one of the highest rates of mycetoma endemicity in the world, though the disease is found throughout the tropics and subtropics. Mycetoma patients are often hindered from timely and appropriate treatment by financial limitations and geographic remoteness from regional health facilities.

In this work had done by Ahmed Fahal, from the University of Khartoum, Sudan, and his colleagues at the Myectoma Research Centre (MRC) adopted a holistic approach to decentralize patient care, improve disease awareness and advocacy, and provide free treatment at the village level. This study was carried out in Eastern Sennar Governate, area of Sudan with 292 villages, and the population of that village is around 219,800, and high rates of mycetoma patients were found. They have decided to visit 19 villages, with four medical and health mobile missions. More than 300 care providers were trained for this purpose only on various aspects of the chronic disease, and meetings were held with local village leaders and activists to gain support.

During the study period, 758 mycetoma suspected patients were identified in Eastern Sennar Governate. In that 220 had ultrasonic evidence of mycetoma and they are qualified for surgery. Immediate access to free treatment reduced patients' delay in starting treatment and reduced the normally high follow-up dropout rate. In addition, a random sample of individuals showed improvement in their knowledge, attitude, and practice toward mycetoma after seeing a dramatic film involving the disease.

The researcher says that The comprehensive approach for Mycetoma implemented in this study has improved the mycetoma patients' quality of care. The MRC, as a WHO Collaborating Centre on Mycetoma, will communicate this experience to the WHO to share it with other mycetoma endemic countries and assist in better management, prevention and control of the disease.