The disabling consequences of Mycetoma
The disabling consequences of Mycetoma
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DOI：
10.1371/journal.pntd.0007019
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发表时间：
2018-12-01
影响因子：
3.8
通讯作者：
Fahal, Ahmed Hassan
中科院分区：
文献类型：
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作者：
Abbas, Mustafa;Scolding, Peter Siordet;Fahal, Ahmed Hassan
足菌肿是一种被忽视的热带病，流行于热带和亚热带国家，特别是苏丹。该疾病的特征是无痛性皮下肿块、多个鼻窦和含有颗粒的分泌物的三联征。它是一种慢性、使人衰弱的疾病，最常影响脚或手，并导致大量发病、功能丧失甚至截肢。它主要影响贫困的农村人口，患者通常会出现晚期疾病和并发症。在这项描述性横断面研究中，我们描述了足菌肿的致残后果。该研究包括 300 名患者； 2016 年 5 月和 2017 年 1 月期间，苏丹喀土穆大学足菌肿研究中心收治了 228 名男性（76%）和 72 名女性（24%）确诊患有足菌肿。该研究设计基于国际功能、残疾和健康分类，检查足菌肿对八个生命领域的影响。我们的主要发现是足菌肿是一种明显致残的疾病。超过 60% 的研究人群（181 名患者）至少在一个领域变量中存在中度损伤或困难。 119 名患者 (39.7%) 报告的重要残疾是行动障碍和行走困难。 103 名患者 (34%) 出现与足菌肿病变相关的显着疼痛，这挑战了足菌肿作为无痛疾病的传统观点。经济负担也很重，有 126 名患者 (46.7%) 报告说他们的自我维持能力受到障碍。这是第一项评估足菌肿致残后果的研究，并显示了干预和进一步研究的明确领域。减轻社会和经济影响的选择包括将镇痛和物理治疗常规纳入治疗方案，以及根据残疾评估调整教育提供和工作实践。我们的数据显示足菌肿是一个公共卫生问题，对生活质量有直接影响。
Mycetoma is a neglected tropical disease endemic in tropical and subtropical countries, particularly Sudan. The disease is characterised by the triad of painless subcutaneous mass, multiple sinuses and discharge that contain grains. It is a chronic, debilitating disease most commonly affecting the feet or hands and leads to substantial morbidity, loss of function and even amputation. It predominantly affects poor, rural populations and patients typically present late with advanced disease and complications. In this descriptive cross-sectional study, we characterise the disabling consequences of mycetoma. The study included 300 patients; 228 (76%) male and 72 (24%) female with confirmed mycetoma seen at the Mycetoma Research Centre, University of Khartoum, Sudan in the period May 2016 and January 2017. The study design was based upon the International Classification of Functioning, Disability and Health, examining the impact of mycetoma on eight life domains. Our major finding is that mycetoma is a significantly disabling disease. Over 60% of the study population (181 patients) had moderate impairment or difficulty in at least one domain variable. The important disability was mobility impairment and walking difficulty that was reported in 119 patients (39.7%). There was significant pain associated with mycetoma lesions in 103 patients (34%), challenging the traditional view of mycetoma as a painless disease. The economic burden was also found to be substantial, with 126 patients (46.7%) reporting barriers to their ability to sustain themselves. This is the first study evaluating the disabling consequences of mycetoma and shows clear areas for intervention and further research. Options for mitigating social and economic impacts include routine integration of analgesia and physiotherapy into treatment protocols, and adapting educational provision and working practices based on disability assessment. Our data show that mycetoma is a public health issue with direct implications on quality of life.