Managing mycetoma: guidelines for best practice

Mycetoma is a serious health problem that is endemic in many tropical and subtropical regions and characterized by devastating deformities, disability and high morbidity. It is a badly neglected disease worldwide. To date, mycetoma’s true incidence, prevalence and route of infection are not well understood; likewise, its susceptibility, resistance and response to medical treatment, which negatively affects patient management. Current treatment, in particular for eumycetoma, has proven to be quite ineffective, have serious side effects and is expensive for patients and health authorities in endemic areas. In general, the eumycetoma treatment outcome is disappointing and is associated with a low cure rate and high amputation and recurrence rates. Late patient presentation is a major problem in mycetoma due to the lack of health education, poor patient socioeconomic status and poor treatment compliance. This is aggravated by a lack of national and international disease awareness, which has led to a massive k...