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A new model for management of mycetoma in the Sudan.

Fahal A, Mahgoub el S, El Hassan AM, Abdel-Rahman ME, Alshambaty Y, Hashim A, Hago A, Zijlstra EE - PLoS Negl Trop Dis (2014)

Bottom Line: Knowledge and practices on mycetoma were found to be significantly associated with age.The integrated management approach adopted in this study is unique and appeared successful and seems suitable as an immediate intervention.While for the longer term, establishment of local health facilities with trained health staff remains a priority.

View Article: PubMed Central - PubMed

Affiliation: Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.

ABSTRACT
Patients with mycetoma usually present late with advanced disease, which is attributed to lack of medical and health facilities in endemic areas, poor health education and low socio-economic status. With this background, an integrated patient management model at the village level was designed to address the various problems associated with mycetoma. The model was launched in an endemic village in the Sudan, between 2010 and 2013. This model is described in a prospective, descriptive, community-based study, aimed to collect epidemiological, ecological, and clinical data and to assess knowledge, attitude and practice (KAP) in order to design effective and efficient management measures. In this study, the prevalence of mycetoma was 14.5 per 1,000 inhabitants. The patients were farmers, housewives and children of low socio-economic status, and no obvious risk group was detected. All had surgery performed in a mobile surgical unit in the village which encouraged patients to present early with small early lesion leading to a good clinical outcome. The close contact with the Acacia tree thorns, animals and animal dung, walking bare footed and practising poor hygiene may all have contributed to the development of mycetoma in the village. Knowledge of mycetoma was poor in 96.3% of the study population, 70% had appropriate attitudes and beliefs towards interaction with mycetoma patients and treatment methods, and 49% used satisfactory or good practices in the management of mycetoma. Knowledge and practices on mycetoma were found to be significantly associated with age. Based on the KAP and epidemiological data, several health education sessions were conducted in the village for different target groups. The integrated management approach adopted in this study is unique and appeared successful and seems suitable as an immediate intervention. While for the longer term, establishment of local health facilities with trained health staff remains a priority.

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Related in: MedlinePlus

Showing a typical house made of mud with roofs made of tree branches with various animals living on the compound.
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Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4214669&req=5

pntd-0003271-g001: Showing a typical house made of mud with roofs made of tree branches with various animals living on the compound.

Mentions: The village has two parts; an older part with poor hygiene, where houses are overcrowded and where often many animals are kept inside the compound or in a fenced area made of Acacia thorny branches that surround the houses. The animals were sheep, cattle, goats, chicken, donkeys, camels and dogs (Figure 1). As a consequence the ground is covered with a layer of animal dung. In the newer part of the village, the houses were separated from each other, less crowded and have better hygiene; in only some of the houses animals were kept in the same compound. The village has small health centre staffed by one doctor, one laboratory technician, one medical assistant and four nurses.


A new model for management of mycetoma in the Sudan.

Fahal A, Mahgoub el S, El Hassan AM, Abdel-Rahman ME, Alshambaty Y, Hashim A, Hago A, Zijlstra EE - PLoS Negl Trop Dis (2014)

Showing a typical house made of mud with roofs made of tree branches with various animals living on the compound.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214669&req=5

pntd-0003271-g001: Showing a typical house made of mud with roofs made of tree branches with various animals living on the compound.
Mentions: The village has two parts; an older part with poor hygiene, where houses are overcrowded and where often many animals are kept inside the compound or in a fenced area made of Acacia thorny branches that surround the houses. The animals were sheep, cattle, goats, chicken, donkeys, camels and dogs (Figure 1). As a consequence the ground is covered with a layer of animal dung. In the newer part of the village, the houses were separated from each other, less crowded and have better hygiene; in only some of the houses animals were kept in the same compound. The village has small health centre staffed by one doctor, one laboratory technician, one medical assistant and four nurses.

Bottom Line: Knowledge and practices on mycetoma were found to be significantly associated with age.The integrated management approach adopted in this study is unique and appeared successful and seems suitable as an immediate intervention.While for the longer term, establishment of local health facilities with trained health staff remains a priority.

View Article: PubMed Central - PubMed

Affiliation: Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan.

ABSTRACT
Patients with mycetoma usually present late with advanced disease, which is attributed to lack of medical and health facilities in endemic areas, poor health education and low socio-economic status. With this background, an integrated patient management model at the village level was designed to address the various problems associated with mycetoma. The model was launched in an endemic village in the Sudan, between 2010 and 2013. This model is described in a prospective, descriptive, community-based study, aimed to collect epidemiological, ecological, and clinical data and to assess knowledge, attitude and practice (KAP) in order to design effective and efficient management measures. In this study, the prevalence of mycetoma was 14.5 per 1,000 inhabitants. The patients were farmers, housewives and children of low socio-economic status, and no obvious risk group was detected. All had surgery performed in a mobile surgical unit in the village which encouraged patients to present early with small early lesion leading to a good clinical outcome. The close contact with the Acacia tree thorns, animals and animal dung, walking bare footed and practising poor hygiene may all have contributed to the development of mycetoma in the village. Knowledge of mycetoma was poor in 96.3% of the study population, 70% had appropriate attitudes and beliefs towards interaction with mycetoma patients and treatment methods, and 49% used satisfactory or good practices in the management of mycetoma. Knowledge and practices on mycetoma were found to be significantly associated with age. Based on the KAP and epidemiological data, several health education sessions were conducted in the village for different target groups. The integrated management approach adopted in this study is unique and appeared successful and seems suitable as an immediate intervention. While for the longer term, establishment of local health facilities with trained health staff remains a priority.

Show MeSH
Related in: MedlinePlus