Department of Medical Microbiology, School of Medicine, College of Medical Sciences, University of Benin, Benin City, Nigeria.
Medical Mycology Society of Nigeria, Lagos, Nigeria.
Mycoses. 2023 Jul;66(7):555-562. doi: 10.1111/myc.13581. Epub 2023 Mar 7.
Mucorales fungi cause mucormycosis, an invasive and rapidly progressive disease which increasingly affects mostly immunocompromised but also immunocompetent individuals. The objective of this study was to highlight the epidemiology, diagnostic modalities, treatment and overall survival of mucormycosis in Africa. We searched for relevant publications in PubMed, Google Scholar and African Journal Online databases covering the period 1960-2022. A total of 147 articles were identified, of which 66 were included in the review, detailing 408 individual cases from 12 African countries; 330 (80.9%) from North Africa, 63 (15.4%) from Southern Africa, seven (1.7%) from East Africa, seven (1.7%) from West Africa and a single case (0.2%) from Central Africa. The most frequently described clinical forms were rhino-orbital-cerebral (n = 307, 75.2%) and gastrointestinal (n = 51, 12.5%). Diabetes mellitus, COVID-19, malignancies and neutropaenia were the commonest underlying risks in 203 (49.8%), 101 (24.8%), 65 (15.9%) and 53 (13.0%) cases respectively. Most cases, 296 (72.5%) were diagnosed by histopathology. Fungal aetiology was identified in 38 (9.3%), of which the commonest was Rhizopus oryzae/arrhizus (27/38, 71.1%). Of the 408 cases, 334 (81.9%) patients received antifungal therapy, while 244 (59.8%) had surgery. In cases with a specified outcome, survival rate was 59.1% (228/386). Based on case reporting, a substantial burden of mucormycosis occurs in North Africa but the disease is rarely reported in most of the sub-Saharan region. Establishing a comprehensive registry for standardised data collection could improve understanding of the epidemiology of mucormycosis in the region.
毛霉目真菌引起毛霉病，这是一种侵袭性和快速进展性疾病，越来越多地影响主要是免疫功能低下的人群，但也影响免疫功能正常的人群。本研究的目的是强调非洲毛霉病的流行病学、诊断方式、治疗和总体生存率。我们在 PubMed、Google Scholar 和 African Journal Online 数据库中搜索了 1960 年至 2022 年期间的相关出版物。共确定了 147 篇文章，其中 66 篇被纳入综述，详细介绍了来自 12 个非洲国家的 408 例个体病例；其中 330 例（80.9%）来自北非，63 例（15.4%）来自南部非洲，7 例（1.7%）来自东非，7 例（1.7%）来自西非，1 例（0.2%）来自中非。最常描述的临床形式是鼻-眶-脑（n=307，75.2%）和胃肠（n=51，12.5%）。糖尿病、COVID-19、恶性肿瘤和中性粒细胞减少症是 203 例（49.8%）、101 例（24.8%）、65 例（15.9%）和 53 例（13.0%）病例中最常见的潜在风险。大多数病例（296 例，72.5%）通过组织病理学诊断。38 例（9.3%）病例确定了真菌病因，其中最常见的是米根霉/根毛霉（27/38，71.1%）。在 408 例病例中，334 例（81.9%）接受了抗真菌治疗，而 244 例（59.8%）接受了手术。在有明确结果的病例中，生存率为 59.1%（228/386）。基于病例报告，北非地区毛霉病的负担很大，但撒哈拉以南地区的大多数地区很少报告这种疾病。建立一个全面的登记处，进行标准化的数据收集，可以提高对该地区毛霉病流行病学的认识。
