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. 2023 Jan 3;117(1):1-11.
doi: 10.1093/trstmh/trac085.

A scoping review of mycetoma profile in Egypt: revisiting the global endemicity map

Sarah A Ahmed  1   2 , Tamer A El-Sobky  3 , Sybren de Hoog  1   2 , Sherif M Zaki  4 , Mohamed Taha  5
Affiliations

A scoping review of mycetoma profile in Egypt: revisiting the global endemicity map

Sarah A Ahmed et al. Trans R Soc Trop Med Hyg. .

Abstract

Mycetoma is a chronic infectious disease endemic in sub-Saharan Africa (SSA), India and parts of South and North America. The epidemiologic profile of the disease in Egypt, which neighbours SSA, has not been explored previously. Therefore we conducted a scoping review of the literature on mycetoma in Egypt. We searched the literature comprehensively on MEDLINE and Google Scholar using free-text words and Medical Subject Headings and terms. Both published and non-peer-reviewed (grey literature) articles were included. The initial search identified 133 reports. Of these, only eight were found to be relevant and were included in the study. The total number of mycetoma patients was 59, reported between 1949 and 2015. There was a predilection for eumycetoma (44 of 59) patients (75%), while actinomycetoma constituted 15 patients (25%). Six patients were female, 28 were male and 25 were unreported. Children and adolescents constituted 3 of 59 (5%), 52 (88%) were adults and age was not provided for 4 patients. Only four patients (7%) were non-autochthonous. The incidence of mycetoma in Egypt is higher than previously reported. Egypt is probably a low-endemic country. An accurate estimate of the prevalence and epidemiology of mycetoma necessitates further research collaboration.

Keywords: Egypt; actinomycetoma; epidemiology; eumycetoma; neglected tropical diseases; northern Africa.

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Figures

Figure 1.
Figure 1.
Diagram of the literature extraction process.
Figure 2.
Figure 2.
(A) Black grains collected from discharging sinuses. (B) Direct examination of a crushed grain of eumycetoma (×400).
Figure 3.
Figure 3.
An adolescent boy from rural Egypt with eumycetoma osteomyelitis of calcaneus. (A) T2-weighted MRI shows dot-in-circle sign. (B) Operative image of superior calcaneus following calcanectomy shows extensive black grains and articular cartilage erosions (hollow white/black arrows). Adopted from El-Sobky et al.
Figure 4.
Figure 4.
Eumycetoma of the foot caused by M. mycetomatis.
Figure 5.
Figure 5.
(A) Actinomycetoma of the foot caused by N. asteroides. (B) Lactophenol cotton blue preparation and (C) culture of N. asteroides from white grain actinomycetoma.
Figure 6.
Figure 6.
Mycetoma world map revisited. Note the inclusion of Egypt as a low-endemic country. Figure redrawn from Emery and Denning.
Figure 7.
Figure 7.
The number of published mycetoma cases in Egypt for the period of 1940–2021.
See this image and copyright information in PMC

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