In mycetoma, there are no clinical management guidelines, protocols and care pathways yet. There are a great need to develop them by a panel of international experts in both eumycetoma and actinomycetoma as are instrumental for improving therapeutic management.
Their development processes have to be participatory with stakeholders’ involvement. They should guide the long term clinical and laboratory follow-up and the necessary post-operative needs of these patients.’ However, they have to be evidence-based, rigorously developed, relevant, clear, and applicable to solve patients’ problems.
To benefit from these guidelines, protocols and care pathways, the local or regional laboratories and other diagnostic facilities have to be reasonably equipped to perform the essential and necessary investigations to confirm the diagnosis of mycetoma; its type and extent, which is essential for proper management.
In addition, availability and continuity of access to medicines are important for mycetoma patients and a good system of drugs distribution is mandatory. Supervision of care providers is important for problem solving and in job training and continuous work improvement is essential. Furthermore, an accurate recording and reporting system is needed to document patients' information for further analysis.