Department of Medical Microbiology & Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria.
Dermatology unit of Institut d'Hygiene Sociale de Dakar Hospital, Faculty of Medicine Pharmacy Odontology, University Cheikh Anta Diop of Dakar, Dakar, Senegal.
Trans R Soc Trop Med Hyg. 2021 Apr 14;115(4):328-336. doi: 10.1093/trstmh/trab032.
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.
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.
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).
There is a dire need for capacity building, provision of facility and health education to raise awareness of this debilitating disease in West Africa.
足菌肿是一种被忽视的疾病,在社会经济方面非常重要,如果不早期治疗,感染者可能会永久残疾。在资源有限的环境中,如西非,这种情况尤其如此,因为那里缺乏设施和熟练的人员来进行明确的实验室诊断。西非国家的气候条件与苏丹相似。大多数患者在已经出现骨感染并导致截肢时才寻求医疗,因此就诊时间很晚。这导致文献中对该问题真实负担的描述严重不足。
对文献进行回顾,发现从 1929 年到 2020 年,西非有 2685 例确诊病例,其中塞内加尔占该次区域病例的 74.1%(1943 例),占该地区 16 个国家中的 15 个。
大多数病变发生在脚部,但也有其他部位的报道。农村居民占大多数病例。只有 547 例(20.4%)报告了确定的分离株。放线菌肿占病例的 47.9%,真菌肿占 39.7%,未确定病原体占 12.4%。被分离出的最主要病原体是佩氏游动放线菌(21.4%;117 株)。
西非非常需要进行能力建设、提供设施和开展健康教育,以提高人们对这种使人衰弱疾病的认识。