Global Burden of Human Mycetoma: A Systematic Review and Meta-analysis

Abstract

Mycetoma is a chronic infectious disease of the subcutaneous tissue with a high morbidity. This disease has been reported from countries between 30°N and 15°S since 1840 but the exact burden of disease is not known. It is currently unknown what the incidence, prevalence and the number of reported cases per year per country is. In order to estimate what the global burden of mycetoma is, a meta-analysis was performed. In total 50 studies were included, which resulted in a total of 8763 mycetoma cases. Most cases were found in men between 11 and 40 years of age. The foot was most commonly affected. Most cases were reported from Mexico, Sudan and India. Madurella mycetomatis was the most prevalent causative agent world-wide, followed by Actinomadura madurae, Streptomyces somaliensis, Actinomadura pelletieri, Nocardia brasiliensis and Nocardia asteroides. Although this study represents a first indication of the global burden on mycetoma, the actual burden is probably much higher. In this study only cases reported to literature could be used and most of these cases were found by searching archives from a single hospital in a single city of that country. By erecting (inter)national surveillance programs a more accurate estimation of the global burden on mycetoma can be obtained.

Non-Invasive Management of Madura Foot with Oral Posaconazole and Ciprofloxacin

“…5 Most cases were described in men as compared with women with 70% of cases found in persons between 11 and 40 years of age. The foot was the most affected body site (68.7%) followed in declining frequency by the leg (9.9%), trunk (6.1%), and arm (4.0%).…”

“…The foot was the most affected body site (68.7%) followed in declining frequency by the leg (9.9%), trunk (6.1%), and arm (4.0%). 5 Eumycetomas are endemic in Africa, the Indian subcontinent, and Latin America, whereas Actinomycetomas predominate in the Americas, with a majority of all cases in Mexico. In a meta-analysis of case reports conducted in 2013, almost 8,763 cases of Mycetoma were identified of which the majority of cases were reported from Mexico (2,607 cases), Sudan (2,555 cases), and India (1,392 cases).…”

Chronic swelling of the foot

“…Mycetoma, first described in the Madura district of India in 1842 [1][2][3], is a clinical entity referring to a chronic, debilitating, granulomatous disease of soft tissues, usually of the foot, resulting from infection either with filamentous bacteria (actinomycetoma) or true fungi (eumycetoma) [1,2,[4][5][6]. It is endemic in equatorial, tropical, and subtropical regions, including the Middle East [1,4,5], but is not well known in the USA and Europe [5], except in migrant populations [7].…”

“…Data on its prevalence have been few and far between. A meta-analysis by van de Sande et al in 2013 reviewed several single-center studies from various countries and estimated a prevalence between <0.01 to 3.49 cases per 100,000 inhabitants, with Mexico, Sudan, and India being the most commonly affected countries [3]. Patients are typically male [1,3,6] and under 30 years old [3,6].…”

“…A meta-analysis by van de Sande et al in 2013 reviewed several single-center studies from various countries and estimated a prevalence between <0.01 to 3.49 cases per 100,000 inhabitants, with Mexico, Sudan, and India being the most commonly affected countries [3]. Patients are typically male [1,3,6] and under 30 years old [3,6]. An update from the Mycetoma Research Center in Sudan released in 2015 predicted higher numbers in the future, with possibly more accurate estimates of its exact global burden as more research and surveillance programs are implemented [6].…”