Report on the Mycetoma Research Centre, University of Khartoum Medical and Health Mission to Wad Onsa Village, Eastern Sennar Locality, Sennar State, Sudan, 8-10th January 2020

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Overview:

The Mycetoma Research Centre (MRC), University of Khartoum, a WHO Collaborating Centre on Mycetoma in collaboration with the Ministry of Health, Sennar State, the Association of Aid & Relief, Japan (AAR), the Institute of Endemic Diseases (IEND), University of Khartoum, Sennar University had conducted a medical and health mission to Wad Onsa Village, Eastern Sennar locality, Sennar State in the period 8-10 January 2020.  This is the seventh mission to the region.

 

Mission Team: 

Mission Objectives:

The mission objectives were to conduct the following activities at Eastern Sennar Locality, Sennar State:

  1. Early mycetoma case detection.
  2. Surgical and medical treatment
  3. Mycetoma awareness and advocacy improvement
  4. Environmental study of some endemic villages
  5. Inauguration of the Wad Onsa Regional Centre Laboratory

Study Area:

The study area was Sinner State which is located in central Sudan and has an area of 37,844 km² and a population of approximately 1,100,000. It is bordered by Gezira State to the north, White Nile State to the west, Gedaref State to the east, Blue Nile State and South Sudan to the South, with an area of 40.680 square kilometers. The mission was in Wad Onsa village which is one of Sinner State villages, located on the north-eastern part of the state, on the west bank of the Aldindir River ata distance of 37 kilometers from Sinner town. It is considered as one of the major Alsuki Foundation agricultural villages.

The medical care and treatment

Sennar Radio and TV had widely announced the mission activities and had encouraged the people to report for free treatment prior to mission arrival to the village. The locality medical assistants and community leaders were contacted to send suspected patients to Was Onsa Mycetoma Regional Centre (WOMRC) for diagnosis confirmation and treatment.

Eighty-five suspected patients were seen and examined for evidence of mycetoma at the WOMRC out-patient clinic. Ultrasound examinations of the suspected lesions were done by a mobile ultrasound machine. Twenty-eight patients had lesions suspected to be mycetoma, and they underwent wide local excisions under spinal or local anaesthesia.

40 patients had operative evidence of black grains eumycetoma. All patients had uneventful postoperative recovery with no complications. All mycetoma patients had post-operative oral Itraconazole in a dose of 200mg BD daily.

All investigations and medical and surgical treatment were offered free of charge. All the surgical biopsies were sent for histopathological examinations and grains culture to confirm the diagnosis of mycetoma.

Health Education

The Health Education Team was led by a social worker from the Association for Aid and Relief, Japan, Khartoum Office and a team of local Community Youth Organisation. Several health awareness events were conducted 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.

Environmental Sampling:

Environmental samples were collected from seven villages in the locality. Seventy samples were collected from the soil. These samples will be analysed for their chemical properties and isolates meta-genomic analysis.

Wad Onsa Regional Mycetoma Centre Laboratory inauguration  

Wad Onsa Regional Mycetoma Centre Laboratory, at Eastern Sennar locality, Sennar State was inaugurated on Thursday 9th, January 2020 by HE the Governor of Sennar State, Sudan. The laboratory was established by a kind donation from DNDi.  The laboratory is equipped with reasonable equipment for basic microbiological and molecular testing with excellent storage facility. The laboratory technologist will be trained at the Mycetoma Research Centre (MRC), Khartoum on Good Clinical Laboratory Practice and other molecular and mycology techniques.

The Wad Onsa Regional Mycetoma Centre is also equipped with a new Ultrasound machine, and that was supported by the DNDi. These imaging and laboratory equipment will improve the quality of medical service offered by the centre and help in patient’s recruitment for the mycetoma treatment clinical trial currently going on at the MRC.  

It is pertinent to mention that Dr Hago, Consultant Surgeon, Assistant Professor, Sennar University, a leading surgeon at Sennar was appointed a new Wad Onsa Regional Mycetoma Centre Director due to his vast experience in surgery and administration to lead more Centre development and expansion. 

The Mission Outcomes

  1. Early detection of mycetoma cases
  2. Medical and surgical treatment of patients at their local villages
  3. Community awareness and engagement for early case detection
  4. Mycetoma awareness and advocacy
  5. Better patients access to treatment
  6. Inauguration of WOMRC Laboratory
  7. Soil samples collection for analysis

Acknowledgement:

The MRC would like to express its almost thanks and gratitude to his Excellency General Mohamed Osman, the Governor of Sennar State, Dr Alam EL Huda Mustafa, the Acting Minister of Health, Sennar State, Prof. Banag Hassan Mohammed Ahmed, Sennar University Vice-Chancellor, Dr A Rahman Ahmed, Dean of the Faculty of Medicine, Sennar University, Mr Hago EL Toum, Consultant Surgeon, Sennar University for their kind and generous support and help

Special thanks to Sheikh A Aziz El Bashir Wad Onsa Community Leader and Mr Mohamed A Gadir EL Mamnoon the past Minister of Health, Sennar State for supporting the accommodation, and meals for the whole mission members.