The Mycetoma Research Center, University of Khartoum, Khartoum, Sudan.
PLoS Negl Trop Dis. 2023 Nov 16;17(11):e0011736. doi: 10.1371/journal.pntd.0011736. eCollection 2023 Nov.
Mycetoma is a chronic, incapacitating, destructive inflammatory disease with many serious damaging impacts. Currently, there is no control or prevention program as many of its epidemiological characteristics, such as the causative organisms' ecological niche, natural habitat, primary reservoir, transmission mode, geographical distribution, incidence, and prevalence, remain unclear. This may be due to a lack of research interest, as mycetoma is still a neglected disease and the scarcity of accurate molecular diagnostic techniques in disease-endemic regions for accurate causative microorganisms identification and mapping. With this background, this study set out to address this knowledge gap by considering the mycetoma environmental occurrence predictors. The medical literature obtained data showed a close association between mycetoma occurrence and its environment. The causative microorganisms are available in the environment in active or dormant forms. Animal dung may be a natural niche and reservoir for these organisms, and thorns may facilitate the subcutaneous inoculation. Some environmental factors, such as the soil type and consistency, temperature, water sources, aridity index, and thorny trees, may be risk factors. The population in endemic areas socioeconomic, hygiene, and health education status are contributory factors for mycetoma. The individual's genetic and immunological backgrounds may determine the disease's susceptibility and resistance. Environmental conditions and personal hygiene improvement are mandatory to reduce disease occurrence. Mycetoma spatial mapping can detect disease cluster areas and then develop public health strategies for early case detection and management to reduce the disease burden. More research interests and facilities are needed to understand disease pathogenesis and appropriate patient management better.
足菌肿是一种慢性、使人丧失能力且具破坏性的炎症性疾病，具有许多严重的破坏性影响。目前，尚无控制或预防计划，因为其许多流行病学特征，如病原体的生态位、自然栖息地、主要宿主、传播模式、地理分布、发病率和患病率仍不清楚。这可能是由于缺乏研究兴趣所致，因为足菌肿仍然是一种被忽视的疾病，而且在疾病流行地区缺乏准确的分子诊断技术，无法准确鉴定病原体并进行定位。有鉴于此，本研究旨在通过考虑足菌肿的环境发生预测因子来解决这一知识空白。从医学文献中获取的数据表明，足菌肿的发生与其环境密切相关。病原体以活跃或休眠的形式存在于环境中。动物粪便可能是这些微生物的天然栖息地和储存库，而荆棘可能有助于皮下接种。一些环境因素，如土壤类型和质地、温度、水源、干旱指数和多刺树木，可能是危险因素。流行地区的人群的社会经济、卫生和健康教育状况是足菌肿的促成因素。个体的遗传和免疫背景可能决定疾病的易感性和抵抗力。改善环境条件和个人卫生是减少疾病发生的必要条件。进行足菌肿空间绘图可以检测出疾病聚集区，然后制定公共卫生策略，以便早期发现和管理病例，从而减轻疾病负担。需要更多的研究兴趣和设施来更好地了解疾病的发病机制和适当的患者管理。
