A decade after WHO recognition, mycetoma still languishes as a neglected disease
Ten years after the WHO listed mycetoma as a neglected tropical disease, patients like Ethiopia's Tesfaye still face inadequate treatment and severe disability.
A young farmer from Mekdela, Ethiopia, contracted mycetoma after a thorn punctured his foot, leading to bone destruction and multiple failed traditional treatments. Although the World Health Organization added mycetoma to its neglected tropical disease list in 2016, progress has been uneven, with limited funding and persistent gaps in care. A 2017 trial in Sudan showed that the weekly drug fosravuconazole matches the efficacy of the costly daily itraconazole, and an open-source initiative, MycetOS, has screened over 2,000 compounds for new therapies.
Advances in PCR diagnostics now enable faster differentiation between fungal and bacterial forms, while burden-of-disease surveys are underway in Ethiopia, Senegal, India, and Kenya. The conflict-driven destruction of the Mycetoma Research Center in Sudan temporarily halted services, though founder Ahmed Hassan Fahal is rebuilding a satellite clinic. Experts stress the need for coordinated research networks, integration of mycetoma into national health systems, and preventive measures such as protective footwear to curb this poverty-linked disease.
Why it matters
Mycetoma causes preventable disability and death, yet remains under-resourced despite global recognition.
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