For various understandable reasons, the true incidence and prevalence of mycetoma throughout the world are not exactly known. These reasons include the nature of the disease, which is usually painless, slowly progressive, and the late presentation of the majority of patients due to the lack of health education and financial constraints. In many centers, amputation is still the sole treatment for advanced cases, which may contribute to the fear of many mycetoma patients to seek medical advice. The medical records and statistical information, in most of the mycetoma endemic health facilities are deficient and hence the lake of adequate data on mycetoma incidence. In many rural communities, mycetoma is a social stigma in particularly among females.
In mycetoma endemic areas, due to several reasons, many individuals pursue medical help from local native healers and that is another cause for the late presentation of patients. Therefore, most of the data on mycetoma are related to hospital cases with advanced disease.
Adapted from: van de Sande WWJ (2013) Global Burden of Human Mycetoma:
A Systematic Review and Meta-analysis. PLoSNegl Trop Dis 7(11): e2550. doi:10.1371/journal.pntd.0002550
Although the Sudan is considered the mycetoma homeland, data on its prevalence and incidence are meager and scanty. Since no real prevalence studies are performed, prevalence can only be roughly estimated based on epidemiological studies. Two large epidemiological studies have been performed on which an artificial and largely underestimated prevalence can be calculated. These are the studies performed by Abbott in Sudan in 1952-1955 and that reported by Lopez Martinez and colleagues from Mexico between 1956 and 1985.
In Abbott’s study, 1231 mycetoma cases were admitted to hospitals throughout the country in a period of 2.5 years. By dividing this number of cases seen in hospitals by the total population of Sudan in those years a prevalence of 4.6 cases per 100,000 inhabitants will be obtained. No incidence data can be calculated.
Lopez Martinez reported on 2105 mycetoma cases from 14 dermatological centers throughout Mexico in a period of 30 years. Again,by applying the same formula an average prevalence of 0.6 cases per 100,000 inhabitants will be obtained. These grossly underestimated incidences are comparable to those of other neglected tropical infections such as Buruli ulcer, African trypanosomiasis, dracunculiasis and leprosy.
More recent data were reported from the Mycetoma Research Centre, WHO Collaborating Centre on mycetoma, Khartoum, Sudan, the only one of its kind in the country. This center reported on 6,792 patients with mycetoma and an incidence of 370 new cases per year in the period 1991-2015.