Bridging gaps in the elimination of deep mycoses: a comparative analysis of mycetoma and chromoblastomycosis control strategies in Rwanda and China.

Abstract

Deep mycoses, largely caused by mycetoma and chromoblastomycosis, is a chronic fungal infection prevalent in tropics and subtropics regions. Deprived populations in these regions are disproportionately affected. However, control strategies for deep mycoses on a global scale remain limited even though these diseases are included in WHO's roadmap for 2021-2030 NTDs. China and Rwanda, with distinct climates, economic conditions and health systems and policies, are both burdened with this debilitating fungal infection. This review, therefore, focused on providing a cross-case evaluation of the control strategies for mycetoma and chromoblastomycosis in Rwanda and China by assessing their epidemiology, diagnostics, treatment accessibility and policy frameworks in an effort to find actionable strategies for elimination. Evidence in the control strategies in these different countries can help improve the management of deep mycoses. Rwanda can learn more about advanced diagnostic technologies from China, while China may benefit from adapting the community-based approach from Rwanda. Enhancing surveillance, declaring mycetoma as notifiable disease, and encouraging international cooperation are essential for meeting the WHO 2030 NTD elimination targets.