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

Abstract

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.

Fig 1. Geographical distribution of mycetoma in the sixty villages in Eastern Sennar Locality, Sennar State, with a total population of 41,176 individuals.

Base map of Sudan link: https://www.diva-gis.org/datadown. A-Sudan states map with Sennar State in red. B-Sennar State Localities with Eastern Sennar Locality in red. C-Geographical distribution of mycetoma in Eastern Sennar locality.

Fig 2. Flow diagram of the total population covered in the survey and the suspected cases identified after clinical examination.

It also describes the category of the patients after ultrasound examination.

Fig 3. Physical distribution of mycetoma lesions for female (left side) and male (right side) cases.

The feet constituted more than 60% of the sites of the lesion in both males and females. The fewest lesions were recorded on the neck and perineum for males and on the neck, trunk, and elbows.

Fig 4. Bar plot of the prevalence of mycetoma among different age groups according to gender.

Males had a higher prevalence among the age groups 0–15 years and more than 60 years, and females recorded a higher prevalence among the other age groups.