Global sociodemographic, clinical, and epidemiological profiling of patients with mycetoma: A systematic review
Bibliographic record
Abstract
BACKGROUND: Mycetoma is a neglected tropical disease that affects subcutaneous tissues. This chronic granulomatous inflammatory disease often leads to high morbidity rates, including amputation, disability and social stigma. Despite its substantial impact, the epidemiology of mycetoma remains largely unknown. This systematic review aimed to establish a global sociodemographic and clinical profile of affected patients and characterise the geographic patterns of the causative organisms of mycetoma. METHODS: The study followed the 'Preferred Reporting Items for Systematic Review and Meta-Analysis' (PRISMA). The search strategy covered all key databases without restriction on language, setting, or year of publication. All observational studies in which the mycetoma patients' sociodemographic profile was described were included. Study quality was evaluated using a modified Newcastle-Ottawa Quality Assessment Scale. We calculated the mean percentage of patients reporting sociodemographic and clinical characteristics. We also determined the geographic patterns of the identified causative organism for reported mycetoma patients based on actinomycetoma and eumycetoma aetiology and genus-level taxonomic classifications. The included studies were heterogeneous in terms of population source, data collection method, and reported data from demographic characteristics to outcomes. This, in turn, can be due to the absence of a standardised data reporting form for mycetoma, which has limited the data analysis and our ability to compare patient characteristics and disease epidemiology over time and between regions. RESULTS: Of 16,564 studies identified, 72 met the inclusion criteria, covering 35,004 persons, of which 29,328 were patients with mycetoma. We found that most cases originated from Sudan, India, and Mexico. The disease primarily affected males (74%) and rural residents (73%), with farmers being the most common occupation. Most patients were adults aged between 20 and 50 years (mean 36.2 years), and the lower limb was affected most (77%). Thirty-three percent of patients were cured on treatment, 15% had amputations, and 18% experienced recurrence. Eumycetoma was predominantly identified in Africa and the Arabian Peninsula, and actinomycetoma was more common in India and Mexico. The most common causative species were Madurella mycetomatis and Actinomadura madurae. CONCLUSION: This review provides a current understanding of the sociodemographic and clinical characteristics of patients with mycetoma worldwide. Most affected cases were adult males and rural residents, with the lower limb involvement being the most common. The distribution of causative organisms varied by region. The variability in outcomes and organisms underscores the complexity of the disease, highlighting the need for further research to understand its global impact.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.008 |
| Bibliometrics | 0.008 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".