Mycetoma epidemiology, diagnosis management, andoutcome in three hospital centres in Senegal from 2008 to2018
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Date
2020-04-24
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Sow et al.
Abstract
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.
Description
PloS one, 15(4), e0231871.
Keywords
Mamadou D. Kanté, Fatoumata Ly, Pauline Dioussé, Babacar T. Faye, Abdou Magip Gaye, Cheikh Sokhna, Stéphane Ranque, Babacar Faye
Citation
Sow, D., Ndiaye, M., Sarr, L., Kanté, M. D., Ly, F., Dioussé, P., ... & Faye, B. (2020). Mycetoma epidemiology, diagnosis management, and outcome in three hospital centres in Senegal from 2008 to 2018. PloS one, 15(4), e0231871.