What is mycetoma?
Mycetoma is a chronic, granulomatous, progressively destructive infectious disease of the subcutaneous tissues, affecting skin, muscle and bone. The disease results from infection caused by more than 70 microorganisms of bacterial or fungal origin. Mycetoma is classified as actinomycetoma (bacterial mycetoma) or eumycetoma (fungal mycetoma) based on its causative agent.
Mycetoma, mainly affects poor, rural populations, particularly people of low economic status who walk barefoot, and manual workers, such as agricultural laborourers and herdsmen.
If not detected and managed early, mycetoma can cause gross deformity of the limbs causing intense suffering, loss of function and impaired ability to work to earn a living, and in advanced cases, lead to amputation and death. This has numerous adverse medical, health and socioeconomic consequences for patients, communities and health services in affected areas.
The way mycetoma is transmitted has not been fully elucidated. Treatment is long and costly and outcomes are often unsatisfactory, which discourages patients from reporting to health centres for care. Furthermore, no rapid diagnostic tests are available for use within the primary health care system.
More work needs to be done as little is known about the incidence and prevalence of mycetoma worldwide. Documented cases show that Sudan reports one of the highest numbers of cases in the world. Other countries with relatively high numbers that form part of the so-called mycetoma belt include the Bolivarian Republic of Venezuela, Chad, Ethiopia, India, Mauritania, Mexico, Senegal, Somalia and Yemen. Targeted for control by 2030 in at least 15 countries, WHO is advocating for its inclusion in national control programmes and surveillance systems.
Following the recognition of mycetoma as a neglected tropical disease by the Sixty-ninth World Health Assembly in 2016 through adoption of resolution WHA 69.21, global measures have been initiated, including an assessment of current policies and practices in 164 countries, a global consultation to identify priority areas of work and the establishment of a Global Mycetoma Working Group.
The Sixth International Conference on Mycetoma was preceded by the First International Training Workshop on Mycetoma from 10 to 14 February 2019 in Khartoum, Sudan. The workshop was organized by WHO and the Mycetoma Research Centre with the support of the Drugs for Neglected Diseases initiative (DNDi).