Early mycetoma case detection:

Since 2015, the MRC missions to the satellite centre had conducted several house to house surveys among the different villages in the locality. The surveys aimed for early case detection and refer the suspected cases to the satellite centre for management.

All suspected cases underwent a meticulous clinical interview and clinical examination at their villages. The patients' suspected lesions and their geographical localities were collected by an electronic data collection deceive and then sent to the  MRC and WOMSC. At the satellite centre, they further had clinical examination, followed by lesional ultrasound examination. All patients with ultrasound suspected lesion underwent surgical excision unless there were contra-indications then they were referred to MRC for further investigations and treatment.

The survys conducted  recently

Surgical and Medical Treatment

All suspected mycetoma cases referred to the centre are seen either before the MRC mission's arrival or during the mission stay. All patients undergo a careful clinical examination and lesions ultrasound examination to confirm the diagnosis. The suspected patients underwent preoperative preparation, surgical intervention and close post-operative following. The post-operative wound dressing was arranged at the centre or at their local health units. All these services are given free of charge. Patients are given mycetoma treatment with follow up visit. More than 1200 ultrasound examinations and 1000 surgeries were done free of charge.

Training of Medical and Health Staff

The medical and health personnel at the Eastern Sennar region received several training courses on mycetoma patients’ care, indications for referral, population health education and disease advocacy. Clinical and ultrasound training at the satellite centre were conducted regularly. The training sessions were addressed by the  Sennar  State  Minister of  Health and  Eastern  Senner locality Governor.  Newly designed referral cards were distributed to the trainee.        

Furthermore, the Mycetoma Research Centre, in collaboration with the Ministry of Health, Sennar State, had organised an Awareness & Advocacy Training Workshop for all medical assistants at Sennar State on the  21^st of January 2016 at Sanga Town, the State capital. The training workshop was inaugurated by the HE Sennar State Governor and HE and the Minister of Health. It was attended by 270 medical assistants and the senior staff of the Ministry of Health.      

The training workshop started with a pre-test. Professor Fahal gave a comprehensive talk on the various aspects of mycetoma, followed by objective discussion and post-test.  The post-test results showed remarkable improvement of the participants’ knowledge, attitude and practice to mycetoma.     

The training workshop aimed to be a preparatory step in implementing a new policy to decentralise the mycetoma services to reach the affected communities at Sennar State, to identify the best tools for early mycetoma case detection and management to control the disease transmission and to determine the impact of service decentralisation on patients’ economic and social burden. Read more

Mycetoma Awareness and Advocacy

In collaboration with the MRC missions, the centre had conducted several awareness and advocacy sessions using different innovative techniques. The  MRC advocacy team led by  Khalid Hamid Youssif, Conceptual Visual Artist, a well-known painter and artist, had conducted several health education sessions to the different communities on mycetoma presentation, treatment and control.  The team had conducted several open theatre performances in several villages, took many photos, and prepared a photo exhibition on mycetoma advocacy to raise awareness. Read more

The Association of Aid and Relief, Japan, Khartoum, health promotion team led by the health promotion officers Mrs Hanan Faisal and Mrs Insal Tawour and a local Community Youth Organisation team had conducted several health awareness events using various methods and health education materials. The material included the distribution of note-books on mycetoma for the pupils and children, leaflets and posters. The Community Youth Organisation members had conducted several performances and open interactive theatre shows for awareness and advocacy. The local Red Crescent Organisation had conducted many advocacy sessions, including house to house sessions.

Sennar Radio and TV had conducted several interviews and programmes. They had widely announced the missions’ activities and encouraged people to report for free treatment prior to the village's mission arrival.

The local medical assistants and community leaders were contacted to send suspected patients to Was Onsa Mycetoma Satellite Centre for diagnosis confirmation and treatment.

“We are with you Society”, lead by Mr Aism EL Bana, a mycetoma Ambassador and the top Sudanese celebrity with 40 singers, comedians, fine artists, had conducted a massive campaign to Sennar State. On their way to Sennar, they had conducted several performances and awareness sessions at different towns they pass by. At Sennar, they conducted massive vestigial on mycetoma. Read more

Local Environmental and Hygiene Improvement

The MRC and collaboration with the centre had conducted many sessions to improve many villages local environment and hygiene. These activities were supported by the Local Government at Sennar State and the East Sennar local governate.

By a kind donation from Saimner Engineering Company, Khartoum, 72 new modern animal cages were built outside Wad  EL  Nimear village to reduce the contact with the animals and their excreta and eradicate the thorny cages. Read more

Provision of Artificial Prosthesis

Most of the mycetoma patients are from under-developed communities and of low socio-economic status. They tend to present late with advanced disease where the affected part's amputation may be the only possible treatment. In Sudan and other developing countries, amputation is a social stigma. Many patients just withdraw, lose their social life, job and education. Many of them may go paging or became socioeconomically independent on family members leading to a various negative impact on patients, families and the community

As the MRC, important objectives are to improve these patients' life quality and mycetoma endemic areas communities, it in collaboration with the Sennar State Ministry of Health and EL Zaka Fund, had organised a mission to offer prosthesis for the mycetoma amputees free of charge at their villages by mobilising a mobile workshop to Wad Onsa Mycetoma Satellite centre. 160 free of charge prosthesis were done at the centre. That had saved the amputees and their families the trouble and cost of the travel, time and accommodation at Khartoum.

.

Implementation and Epidemiological Research Conduction

The MRC epidemiology team conducted several house-to-house epidemiological surveys at the different Eastern Sennar locality units to investigate the high incidence and burden of mycetoma.

The first survey was conducted at Wad El  Nimer village, led by  Dr Manar Elsheikh, Associate Professor of Biostatistics, Faculty of Mathematical Sciences, University of Khartoum.  The team collected basic demographic information on all household members and information on the household characteristics. All the suspected mycetoma cases were referred to Wad- El Abbas Hospital for further assessment by the MRC mission team to confirm the diagnosis and management.  Read more

Several immunological and genetic studies were conducted Wad Onsa and Wad El Numir villages to determine any association between the mycetoma high incidence and the affected population background. Read more

A well trained epidemiological team conducted a comparative house-to-house survey at Wad-Onsa and Wad El Numir village using a structured questionnaire for suspected mycetoma patients. environmental samples were collected from the two villages. These samples were processed for DNA extraction for meta-genomic analysis. Read more

A further in-depth study to identify the aetiological and environmental factors that influence the occurrence and distribution of mycetoma at Sennar State and to determine the geographical distribution of mycetoma was conducted.  Read more

More detailed mycetoma geographic distribution in the area was conducted. Further environmental Study to elucidate some angles of occurrence of Mycetoma in eastern Sennar, climatic and ecological factors and proximity to livestock were studied. Read more

Eighteen villages in Doba and Wad Taktok administrative units in the Eastern Sennar locality were studied. House to house survey was conducted in each village for early mycetoma cases detection using the CAPI application using the smart tablets to register the suspected patients’ information. The data collected included the suspected patients’ demographic characteristics, community leaders and health personal contacts and photos of the suspected mycetoma lesions and the villages and the patients’ locality coordinates. The survey team also participated in the health education activities in the surveyed villages. The total number of suspected patients registered was 62 patients. Read more

Community Involvement

Local villages leaders and activities were actively involved in the mycetoma advocacy activities and awareness-raising. The local Red Crescent volunteers trained in mycetoma advocacy, and they had improved the local environmental hygiene in the affected villages through the house to house surveys.

The MRC donated a toktoko (big motorcycle) to a community activist at  Wad EL Nimear village for transporting patients and medicines between the different villages and for mycetoma advocacy.

The Sennar State government, different miniseries and local Radio and TV were actively involved in these activities. Most of the local Mosques Imans, schools teachers were trained on mycetoma advocacy and became motivated. Read more