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. 2021 Oct 1;115(10):1144-1152.
doi: 10.1093/trstmh/trab076.

Modelling the spatial distribution of mycetoma in Sudan

Rowa Hassan  1   2 , Hope Simpson  3 , Jorge Cano  3 , Sahar Bakhiet  1 , Eltayeb Ganawa  4 , Daniel Argaw  5 , Melanie J Newport  2 , Kebede Deribe  2   6 , Ahmed Hassan Fahal  1
Affiliations

Modelling the spatial distribution of mycetoma in Sudan

Rowa Hassan et al. Trans R Soc Trop Med Hyg. .

Abstract

Background: Mycetoma is a neglected tropical disease that is reported worldwide and Sudan has the highest reported number of mycetoma infections across the globe. The incidence, prevalence and burden of mycetoma globally are not precisely known and its risk factors remain largely unelucidated.

Methods: This study aimed to identify the environmental predictors of fungal and bacterial mycetoma in Sudan and to identify areas of the country where these niche predictors are met. Demographic and clinical data from confirmed mycetoma patients seen at the Mycetoma Research Centre from 1991 to 2018 were included in this study. Regression and machine learning techniques were used to model the relationships between mycetoma occurrence in Sudan and environmental predictors.

Results: The strongest predictors of mycetoma occurrence were aridity, proximity to water, low soil calcium and sodium concentrations and the distribution of various species of thorny trees. The models predicted the occurrence of eumycetoma and actinomycetoma in the central and southeastern states of Sudan and along the Nile river valley and its tributaries.

Conclusion: Our results showed that the risk of mycetoma in Sudan varies geographically and is linked to identifiable environmental risk factors. Suitability maps are intended to guide health authorities, academic institutes and organisations involved in planning national scale surveys for early case detection and management, leading to better patient treatment, prevention and control of mycetoma.

Keywords: Sudan; ensemble models; environmental modelling; machine learning; mycetoma.

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Figures

Figure 1.
Figure 1.
Records of mycetoma cases in Sudan (1991–2018); the upper right map shows where Sudan is situated in Africa; the blue dots represent Actinomycetoma and the yellow dots represent Eumycetoma. Mycetoma cases are distributed along the River Nile with a focus on central Sudan. Cases are distributed sporadically in the western part of Sudan.
Figure 2.
Figure 2.
Predicted environmental suitability for eumycetoma in Sudan. Eumycetoma is predicted to occur along the River Nile and its tributaries with hotspots in the central and southeastern parts of Sudan.
Figure 3.
Figure 3.
Predicted environmental suitability for actinomycetoma in Sudan. Actinomycetoma is predicted to occur along the River Nile and its tributaries with hotspots in the central and southeastern parts of Sudan with sporadic occurrence in the western part of Sudan.
Figure 4.
Figure 4.
Overlaps of actinomycetoma and eumycetoma environmental suitability in Sudan. The map shows central Sudan to be the most suitable area for the occurrence of both types of mycetoma.
See this image and copyright information in PMC

References

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