Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia.
<h4>Background</h4>Subcutaneous (deep) mycoses are a chronic infectious disease of the skin and underlying structures endemic in tropical countries. The disease has serious medical and socioeconomic consequences for patients, communities and health services in endemic areas. The inclusio...
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Public Library of Science (PLoS)
2023-09-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011363&type=printable |
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| author | Wendemagegn Enbiale Alemayehu Bekele Nigus Manaye Fikre Seife Zeyede Kebede Filmon Gebremeskel Johan van Griensven |
| author_facet | Wendemagegn Enbiale Alemayehu Bekele Nigus Manaye Fikre Seife Zeyede Kebede Filmon Gebremeskel Johan van Griensven |
| author_sort | Wendemagegn Enbiale |
| collection | DOAJ |
| description | <h4>Background</h4>Subcutaneous (deep) mycoses are a chronic infectious disease of the skin and underlying structures endemic in tropical countries. The disease has serious medical and socioeconomic consequences for patients, communities and health services in endemic areas. The inclusion of mycetoma and other subcutaneous mycoses in the list of Neglected Tropical Diseases by WHO highlights the need to assess the burden of these diseases and establish control programs where necessary. In Ethiopia no strategies can be devised because of a lack of epidemiologic information. To address this evidence gap, we performed a national rapid assessment of the geographic distribution of subcutaneous mycoses.<h4>Methodology</h4>We conducted a rapid retrospective assessment using hospital records to identify all suspected and confirmed cases of subcutaneous mycoses in 13 referral hospitals across the country between 2015 and 2022. In each hospital the logbooks were reviewed for diagnoses of subcutaneous mycosess, as diagnosed per routine practice. Descriptive analysis was done.<h4>Result</h4>From 13 hospitals we extracted 143 cases of subcutaneous mycoses, registered from July 2018 to September 2022. 118 (82.5%) patients were diagnosed as mycetoma, 21 (14.7%) as chromoblastomycosis and the remaining 4 (2.8%) as sporotrichosis. The mean age of patients was 35.8 years (SD = 14.5). 101 (70.6%) patients were male and 96 (67.1%) patients were farmers. 64 (44.8%) cases were from the Tigray regional state. 56 (65.9%) patients had information on diagnostic microscopic evaluation: for mycetoma histopathologic evaluation and fine needle aspiration cytology had a higher positivity rate while for chromoblastomycosis potassium hydroxide (KOH) staining had a better yield. The main clinical presentations were nodules, sinuses and infiltrative plaques on the skin. Radiologic findings of bone involvement was present in some.<h4>Conclusions</h4>Mycetoma and other subcutaneous mycoses are endemic in Ethiopia, with cases reported from almost all regions with the highest cases numbers reported from the northern part of the country. A routine program and systems should be developed to identify and document the burden of subcutaneous fungal infections in the country. Diagnosis and treatment guidelines should be developed. |
| format | Article |
| id | doaj-art-adc21674b16f42d9b10c9e9ae94d64eb |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2023-09-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-adc21674b16f42d9b10c9e9ae94d64eb2025-08-20T03:25:46ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352023-09-01179e001136310.1371/journal.pntd.0011363Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia.Wendemagegn EnbialeAlemayehu BekeleNigus ManayeFikre SeifeZeyede KebedeFilmon GebremeskelJohan van Griensven<h4>Background</h4>Subcutaneous (deep) mycoses are a chronic infectious disease of the skin and underlying structures endemic in tropical countries. The disease has serious medical and socioeconomic consequences for patients, communities and health services in endemic areas. The inclusion of mycetoma and other subcutaneous mycoses in the list of Neglected Tropical Diseases by WHO highlights the need to assess the burden of these diseases and establish control programs where necessary. In Ethiopia no strategies can be devised because of a lack of epidemiologic information. To address this evidence gap, we performed a national rapid assessment of the geographic distribution of subcutaneous mycoses.<h4>Methodology</h4>We conducted a rapid retrospective assessment using hospital records to identify all suspected and confirmed cases of subcutaneous mycoses in 13 referral hospitals across the country between 2015 and 2022. In each hospital the logbooks were reviewed for diagnoses of subcutaneous mycosess, as diagnosed per routine practice. Descriptive analysis was done.<h4>Result</h4>From 13 hospitals we extracted 143 cases of subcutaneous mycoses, registered from July 2018 to September 2022. 118 (82.5%) patients were diagnosed as mycetoma, 21 (14.7%) as chromoblastomycosis and the remaining 4 (2.8%) as sporotrichosis. The mean age of patients was 35.8 years (SD = 14.5). 101 (70.6%) patients were male and 96 (67.1%) patients were farmers. 64 (44.8%) cases were from the Tigray regional state. 56 (65.9%) patients had information on diagnostic microscopic evaluation: for mycetoma histopathologic evaluation and fine needle aspiration cytology had a higher positivity rate while for chromoblastomycosis potassium hydroxide (KOH) staining had a better yield. The main clinical presentations were nodules, sinuses and infiltrative plaques on the skin. Radiologic findings of bone involvement was present in some.<h4>Conclusions</h4>Mycetoma and other subcutaneous mycoses are endemic in Ethiopia, with cases reported from almost all regions with the highest cases numbers reported from the northern part of the country. A routine program and systems should be developed to identify and document the burden of subcutaneous fungal infections in the country. Diagnosis and treatment guidelines should be developed.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011363&type=printable |
| spellingShingle | Wendemagegn Enbiale Alemayehu Bekele Nigus Manaye Fikre Seife Zeyede Kebede Filmon Gebremeskel Johan van Griensven Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia. PLoS Neglected Tropical Diseases |
| title | Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia. |
| title_full | Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia. |
| title_fullStr | Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia. |
| title_full_unstemmed | Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia. |
| title_short | Subcutaneous mycoses: Endemic but neglected among the Neglected Tropical Diseases in Ethiopia. |
| title_sort | subcutaneous mycoses endemic but neglected among the neglected tropical diseases in ethiopia |
| url | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0011363&type=printable |
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