Environment

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Browsing Environment by Subject "Abdou Magip Gaye"

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    Mycetoma epidemiology, diagnosis management, andoutcome in three hospital centres in Senegal from 2008 to2018
    (Sow et al., 2020-04-24) Sow, Doudou; Ndiaye, Maodo; Sarr, Lamine
    Mycetoma is a neglected tropical disease caused by various actinomycetes or fungi. The disease is characterized by the formationof tumor like-swellings and grains. Senegal is an endemic country where mycetoma cases are under-or misdiagnosed due to thelack of capacities and knowledge among health workers and the community; and where the management of eumycetoma,burdened by a high amputation rate, is currently inadequate. This study aimed to update data on the epidemiology of mycetomacases diagnosed in three hospital centres in Senegal over a 10 years-period. A total of 193 patients, diagnosed from 2008 to 2018,were included in the study. The most frequent presentation was eumycetoma (47.2%); followed by actinomycetoma (36.8%); itremained undetermined in 16.1% of the patients. The mean age was 38.3 years (68.4% of the patients were between 15 and 45years-old); the male: female ratio was a 2.94; and most were farmers. One hundred fifty-six (80.8%) patients had usedphytotherapy before attending the hospital. Mycetoma was mainly located to the lower limbs (91.2%). Grains were observed in 85%of the patients; including white (25.6%) and yellow (4.3%) grains. The etiological diagnosis was complex, resulting in negative directmicroscopy, culture and/or histopathology findings, which explains that 16.1% remained uncharacterized. In most of cases,actinomycetoma were treated with a combination of cotrimoxazole, amoxicillin/clavulanic acid, and streptomycin; whereaseumycetoma cases were treated with terbinafine. The surgery was done in 100 (51.8%) of the patients including 9 inactinomycetoma, 78 in eumycetoma and 13 in undetermined form. The high number of uncharacterized mycetoma in this study, thedelay in attending a qualified health-care facility, and the lack of available adequate antifungal drug, point out the need tostrengthen mycetoma management capacities in Senegal.