Epidemiology, risk factors, and awareness of mycetoma among residents in Eastern Sinnar locality, Sudan, 2021

Background: Mycetoma is a chronic granulomatous disease affecting the skin, subcutaneous tissues, and bones, particularly in tropical and subtropical regions. Sudan, especially its Eastern Sinnar locality, experiences a significant burden due to environmental conditions and limited access to healthcare, while the population's lack of awareness and understanding often leads to delays in diagnosis and treatment.

Methods: We conducted a descriptive cross-sectional, community-based study in Eastern Sinnar, Sudan, to investigate the prevalence, risk factors, and awareness of mycetoma among local residents. Using Cochran's formula, we calculated a required sample size of 400 participants from a total population of 245 201. Then, we randomly selected these participants from five villages chosen through stratified sampling. Data were collected via a validated questionnaire assessing sociodemographic characteristics and mycetoma-related information, a review of medical records to confirm infection types and prevalence, and interviews with the Directorate of the Mycetoma Centre in Sinnar. We used χ² tests for associations in our analysis, with P-values ≤0.05 indicating statistical significance.

Results: The mycetoma prevalence was 5.4%, with males comprising 76.4% of infected cases. However, the difference in infection rates between genders was not statistically significant (P = 0.248). While infection rates were higher among certain occupational groups, such as farmers and shepherds, the association between occupation and mycetoma infection was non-significant (P = 0.107). We also found no significant associations with educational level (P = 0.104) or age (P = 0.514), but did detect significant associations for family history of infection (P < 0.001), animal ownership (P = 0.004), and not wearing shoes during work (P = 0.05). Awareness of mycetoma was relatively high, with 78.3% of respondents acknowledging the disease, though knowledge gaps remained, especially regarding its transmission, with only 36.1% believing it to be transmissible.

Conclusions: The study highlights the need for targeted health education programmes, particularly emphasising protective footwear and safe animal-handling practices. These findings are crucial for informing public health strategies aimed at reducing the burden of mycetoma in endemic regions such as Eastern Sinnar.