A possible role for ticks in the transmission of <i>Madurella mycetomatis</i> in a mycetoma-endemic village in Sudan

Azrag, Rasha S.; Bakhiet, Sahar Mubarak; Mhmoud, Najwa Adam; Almalik, Alaa Mahmoud Ali; Mohamed, A H; Fahal, Ahmed Hassan

doi:10.1093/trstmh/trab030

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Ticks are second only to mosquitoes as vectors of human infectious diseases worldwide as they are known disease vectors for various diseases of protozoal, rickettsial, spirochetes, viral, fungal, and bacterial origin, and most of these diseases are of zoonotic origin [65]. A study from a mycetoma-endemic village in Sudan reported, for the first time, PCR detection of Madurella mycetomatis in ticks that may indicate their possible role in the disease transmission [66]. In Sudan, ticks and tick-borne diseases are widespread, in the studied village, ticks highly infest the animals, and the villagers are in direct contact with these animals.…”

Section: Mycetoma and Animals Contactmentioning

confidence: 99%

Mycetoma and the environment

Fahal,

Bakhiet

2023

PLoS Negl Trop Dis

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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.

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Section: Mycetoma and Animals Contactmentioning

confidence: 99%

Mycetoma and the environment

Fahal,

Bakhiet

2023

PLoS Negl Trop Dis

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“…Most of the individuals living in rural areas are in direct contact with animals such as cattle, donkeys, dogs, sheep and chickens. We found no strong evidence supporting a role for animals or their dungs in the development of mycetoma, which needs further in-depth study [19,31].…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 88%

“…Several studies suggested a possible role of animal dung in causing mycetoma as some organisms were isolated from the dung, which may act as a reservoir for them [21,[30][31][32], allowing the direct transmission to the human. Most of the individuals living in rural areas are in direct contact with animals such as cattle, donkeys, dogs, sheep and chickens.…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Clinical epidemiological characteristics of mycetoma in Eastern Sennar locality, Sennar State, Sudan

et al. 2021

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Mycetoma epidemiological features remain uncharacterised. Few studies have been conducted in a community-based setting to explore the epidemiological features and risk factors for mycetoma in Sudan. To bridge this gap, this study was conducted in Eastern Sennar Locality, Sennar State, Sudan, to report the clinical, epidemiological characteristics of mycetoma patients and the disease burden in the state. We used cluster sampling; sixty villages were randomly selected across the locality’s five administrative units, and a household-to-household survey was conducted. We collected data using pre-designed questionnaires at the community, household, and individual levels. We performed descriptive analyses of the data and produced prevalence maps using ArcGIS 10.5 ([ESRI] Inc., Redlands CA, USA). A total of 41,176 individuals were surveyed, and 359 mycetoma patients were identified. The overall prevalence of mycetoma was 0.87% (95%CI = 0.78–0.97%), the prevalence among males was 0.83% (95%CI = 0.71–0.96%), and females 0.92% (95% CI = 0.79–1.06%). Individuals in the age group 31–45 years had the highest prevalence among the different age groups (1.52%, 95% CI = 1.23–1.86%). The prevalence map showed patients clustered within the central and north-eastern part of the locality, while villages in the south-western part had few or no cases. In conclusion, this clinical epidemiological study is pioneering and shows that mycetoma is prevalent in certain parts of Sudan. This data obtained will support the design of measures to reduce the disease burden in the state. The survey procedures and protocols can be adopted for further studies in Sudan and beyond.

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“…People living in rural areas tend to make animal enclosures from the wood of thorny trees and may be at risk of thorn pricks during the construction and maintenance of these structures [9]. As well as being in close contact with the environment, they are likely to be at higher risk of ticks, which are highly prevalent in domestic animals in Eastern Sennar Locality and hypothesized to play a role in the transmission of mycetoma causative agents to humans [25]. The evidence for this route of transmission is not conclusive, however.…”

Section: Discussionmentioning

confidence: 99%

Individual Risk Factors of Mycetoma Occurrence in Eastern Sennar Locality, Sennar State, Sudan: A Case-Control Study

Hassan

Deribe

Simpson

et al. 2022

Preprint

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Mycetoma is a serious chronic subcutaneous granulomatous inflammatory disease that is endemic in tropical and subtropical regions where it impacts profoundly on patients, families, and communities. Individual-level risk factors for the disease are poorly understood. To address this, a case-control study was conducted based on data collected from 60 villages in Eastern Sennar Locality, Sennar State, Sudan. Based on the presence of swelling in any part of the body, or sinus formation with or without grain discharge evident from the lesion by ultrasound examination, we diagnosed 359 cases of mycetoma. For each case, we included three healthy sex-matched persons, with no evidence of mycetoma, from the same village as the controls group (n=1077). The odds for mycetoma were almost three times higher in individuals in the age group 16-30 years (Adjusted Odds Ratio (AOR) = 2.804, 95% CI= 1.424 – 5.523) compared to those in age group ≤15 years. Other factors odds of mycetoma were history of local trauma (AOR =1.892, 95% CI= 1.425 – 2.513), being unmarried (AOR =3.179, 95% CI= 2.339 – 4.20) and owning livestock (AOR =3.941, 95% CI= 2.874 – 5.405). In conclusion, certain factors found to be associated with mycetoma in this study could inform a high index of suspicion for mycetoma diagnosis, which would improve early case detection. Other factors found to be associated could inform the development of an interventional program for mycetoma control in Sudan, including education on healthy farming practices and the risks of puncture wounds for individuals residing in endemic areas. However, this work was conducted in one endemic state, while mycetoma cases occur in all states of Sudan. Replicating this study over a wider area would give a fuller picture of the situation, providing the control program with more comprehensive information on the risk factors for the disease.

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A possible role for ticks in the transmission of Madurella mycetomatis in a mycetoma-endemic village in Sudan

Cited by 7 publications

References 25 publications

Mycetoma and the environment

Mycetoma and the environment

Clinical epidemiological characteristics of mycetoma in Eastern Sennar locality, Sennar State, Sudan

Individual Risk Factors of Mycetoma Occurrence in Eastern Sennar Locality, Sennar State, Sudan: A Case-Control Study

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