Ahmed Hassan Fahal

Ahmed Hassan Fahal
Mycetoma Research Center - University of Khartoum · Soba University Hospital

MBBS, FRCS, FRCSI, FRCS (Gal), MD, MS, FRCP (London) FRCPath
Professor of Surgery University of Khartoum

About

424
Publications
103,162
Reads
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6,801
Citations
Additional affiliations
January 1997 - present
University of Khartoun
Position
  • Professor (Full)
January 1991 - present
Mycetoma Research Center - University of Khartoum
Position
  • Managing Director
January 1989 - present
Position
  • l

Publications

Publications (424)
Article
Full-text available
Eumycetoma is a chronic subcutaneous neglected tropical disease that can be caused by more than 40 different fungal causative agents. The most common causative agents produce black grains and belong to the fungal orders Sordariales and Pleosporales. The current antifungal agents used to treat eumycetoma are itraconazole or terbinafine, however, the...
Article
Full-text available
Mycetoma is a tropical disease caused by several fungi and bacteria present in the soil. Fungal mycetoma and eumycetoma are especially challenging to treat; therefore, prevention, early diagnosis, and early treatment are important, but it is also necessary to understand the geographic distribution of these pathogenic fungi. In this study, we used D...
Article
Full-text available
Introduction: Eumycetoma is a subcutaneous mutilating disease that can be caused by many different fungi. Current treatment consists of prolonged itraconazole administration in combination with surgery. In many centers, due to their slow growth rate, the treatment for eumycetoma is often started before the causative agent is identified. This harbo...
Article
Full-text available
Mycetoma is an extremely neglected tropical disease that still receives insufficient attention from international medical and health communities, non-governmental organizations and research funders. It has serious health and socioeconomic impacts on patients, families, communities and the health system in endemic areas. 1-3 In this communication, w...
Article
Full-text available
S6.5 Efforts of improving the management of mycetoma: working towards the 2030 goals, September 22, 2022, 4:45 PM - 6:15 PM Mycetoma is a debilitating disease recognized as a neglected tropical disease by the World Health Organization. The etiology of mycetoma is poorly understood; ∼ 60% of cases are caused by fungi and the rest are bacterial, alth...
Article
Full-text available
S4.5 Mycetoma Clinical Trial on fosravuconazole treatment in eumycetoma– Top Line Results, September 22, 2022, 10:30 AM - 12:00 PM Objective: To evaluate the pharmacokinetics (PK) of fosravuconazole (measured as ravuconazole) and itraconazole in patients with mild to moderate eumycetoma caused by Madurella mycetomatis using a non-compartmental PK a...
Article
Full-text available
S3.1 Neglected implantation mycoses, September 21, 2022, 4:45 PM - 6:15 PM Mycetoma is a badly neglected tropical disease, reported globally but endemic in many tropical and subtropical, and Sudan has the highest disease burden. Mycetoma epidemiological features remain uncharacterized. Hence, there is no preventive or control program for mycetoma w...
Article
Full-text available
S4.5 Mycetoma Clinical Trial on fosravuconazole treatment in eumycetoma– Top Line Results, September 22, 2022, 10:30 AM - 12:00 PM Objectives Eumycetoma is a neglected tropical disease characterized by large subcutaneous swellings and the formation of grains and most commonly caused by Madurella mycetomatis. The currently recommended therapy is a...
Article
Full-text available
S4.5 Mycetoma Clinical Trial on fosravuconazole treatment in eumycetoma– Top Line Results, September 22, 2022, 10:30 AM - 12:00 PM Objectives Mycetoma is a neglected tropical implantation disease caused by 70 different infectious agents. Identifying the causative organism to the species level is essential for appropriate patient management. Ultras...
Article
Full-text available
Objectives To determine whether, in addition to surgery, fosravuconazole (Fos) monotherapy of either 200 mg or 300 mg weekly was more effective [defined as complete cure at the End of Treatment (EOT; 52-week) visit] than the standard-of-care 12-month regimen of itraconazole (Itra) monotherapy, in patients with small to moderate eumycetoma lesions c...
Article
Full-text available
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objective: Mycetoma is a neglected tropical skin disease, caused by 70 different causative agents. For most of the causative agents, molecular identification is the only reliable method to identify the species level. In practice, ultrasound, histopathology, culturing, and species-specific PCR...
Technical Report
Full-text available
This is a case of the month by the Mycetoma Research Centre, University of Khartoum
Technical Report
Full-text available
This is the Photo of the month
Article
Full-text available
Eumycetoma is a chronic debilitating fungal disease endemic to tropical and subtropical regions, with Sudan featuring the highest eumycetoma incidence. Among the 50 species of fungi most commonly associated with eumycetoma Madurella mycetomatis ( M . mycetomatis ) is often referenced as the most common pathogen. However, there is an enormous knowle...
Article
Full-text available
Mycetoma is a serious chronic subcutaneous granulomatous inflammatory disease that is endemic in tropical and subtropical regions, where it impacts profoundly on patients, families, and communities. Individual-level risk factors for the disease are poorly understood. To address this, a case-control study was conducted based on data collected from 6...
Technical Report
Full-text available
The Mycetoma Research Center (MRC), University of Khartoum, WHO Collaborating Center on Mycetoma has launched its second medical and health mission for El-Managil locality, Gazeria, in collaboration with El Managil University for Science and Technology, the Mycetoma Patients Friends Association (MPFA) and the Association for Aid and Relief (ARR), J...
Article
Background: Eumycetoma is a neglected tropical disease. It is a chronic inflammatory subcutaneous infection characterised by painless swellings which produce grains. It is currently treated with a combination of itraconazole and surgery. In an ongoing clinical study, the efficacy of fosravuconazole, the prodrug of ravuconazole, is being investigat...
Article
Background Mycetoma is a chronic granulomatous inflammatory disease that affects the cutaneous and subcutaneous tissues, leading to gruesome complications if not treated early. As a neglected disease, it has received scant attention in developing curable drugs. Mycetoma treatment is still based on expert opinions in the absence of guidelines. Meth...
Article
Full-text available
Mycetoma is a neglected tropical chronic granulomatous inflammatory disease of the skin and subcutaneous tissues. More than 70 species with a broad taxonomic diversity have been implicated as agents of mycetoma. Understanding the full range of causative organisms and their antibiotic sensitivity profiles are essential for the appropriate treatment...
Article
Full-text available
Eumycetoma is a neglected tropical infection of the subcutaneous tissue, characterized by tumor-like lesions and most commonly caused by the fungus Madurella mycetomatis. In the tissue, M. mycetomatis organizes itself in grains, and within a single lesion, thousands of grains can be present. The current hypothesis is that all these grains originate...
Article
Full-text available
Background: Ultrasound (US)-guided fine-needle aspiration cytology (US-FNAC) has improved the diagnosis of many malignancies, infections, and other diseases as it is safe, simple, quick and accurate. In mycetoma, it is assumed that this technique may have a better diagnostic yield than the conventional FNAC as it can accurately identify the optimal...
Article
In a cross-sectional survey in Omdurman, Sudan, during March-April 2021, we estimated that 54.6% of the population had detectable severe acute respiratory syndrome coronavirus 2 antibodies. Overall population death rates among those >50 years of age increased 74% over the first coronavirus disease pandemic year.
Preprint
Full-text available
Mycetoma is a serious chronic subcutaneous granulomatous inflammatory disease that is endemic in tropical and subtropical regions where it impacts profoundly on patients, families, and communities. Individual-level risk factors for the disease are poorly understood. To address this, a case-control study was conducted based on data collected from 60...
Article
Mycetoma is a chronic granulomatous inflammatory disease that is caused either by bacteria or fungi. Bacterial mycetoma (actinomycetoma) can be caused by various causative agents of the genera Nocardia, Streptomyces and Actinomadura. On the other hand, fungal mycetoma (eumycetoma) is most commonly caused by causative agents belonging to the genera...
Article
Full-text available
Eumycetoma is a neglected tropical disease, and Madurella mycetomatis, the most common causative agent of this disease forms black grains in hosts. Melanin was discovered to be one of the constituents in grains. Melanins are hydrophobic, macromolecular pigments formed by oxidative polymerisation of phenolic or indolic compounds. M. mycetomatis was...
Article
Full-text available
Coronavirus disease 2019 (COVID-19) is a major health problem worldwide and almost every country affected by the disease has experienced a high mortality rate. It has caused 2 460 000 deaths worldwide over a period of 14 months. In Sudan, the virus affected 34 889 individuals, of whom 27 949 recovered, while 2568 deaths occurred. The COVID-19 pande...
Preprint
Full-text available
Mycetoma is a neglected tropical chronic granulomatous inflammatory disease of the skin and subcutaneous tissues. More than 70 species with a broad taxonomic diversity have been implicated as agents of mycetoma. Understanding the full range of causative organisms and their antibiotic sensitivity profiles are essential for the appropriate treatment...
Article
Full-text available
Mycetoma epidemiological features remain uncharacterised. Few studies have been conducted in a community-based setting to explore the epidemiological features and risk factors for mycetoma in Sudan. To bridge this gap, this study was conducted in Eastern Sennar Locality, Sennar State, Sudan, to report the clinical, epidemiological characteristics o...
Article
Full-text available
Mycetoma is a neglected tropical disease that is associated with poor communities and socioeconomically impaired individuals in the tropical and subtropical areas. Interestingly, the disease is caused by either bacteria (actinomycetoma) or fungus (eumycetoma). The latter form of the disease, eumycetoma, is the most common type in Africa. Eumycetoma...
Preprint
Full-text available
Background Even after adjusting for the expected lower severity due to the younger age of the population, relatively low SARS–CoV–2 incidence and mortality rates have been reported throughout Africa. For investigating whether this is truly the case, we conducted a survey to estimate the COVID–19 related mortality and cumulative incidence of SARS–Co...
Article
For many fungal infections, in vitro susceptibility testing is used to predict if an isolate is resistant or susceptible to the antifungal agent used to treat the fungal infection. For Madurella mycetomatis , the main causative agent of mycetoma, in vitro susceptibility testing currently is not performed on a routine basis. The current in vitro sus...
Article
Full-text available
Mycetoma is a devastating neglected tropical infection of the subcutaneous tissue and most commonly caused by the fungus Madurella mycetomatis . Treatment of mycetoma consists of a combination of a long term antifungal treatment with itraconazole and surgery. However, treatment is associated with low success rates. Therefore, there is a need to ide...
Article
Full-text available
Objectives: Rheumatoid arthritis is a chronic inflammatory autoimmune disease. This study aimed to determine the association of interleukin-17A-197G/A polymorphism with rheumatoid arthritis in Sudanese patients. Methods: A case-control study was conducted between March and December 2018. Clinical and demographic data of the study participants we...
Article
Full-text available
Background Mycetoma is a neglected tropical disease that is reported worldwide and Sudan has the highest reported number of mycetoma infections across the globe. The incidence, prevalence and burden of mycetoma globally are not precisely known and its risk factors remain largely unelucidated. Methods This study aimed to identify the environmental...
Article
Background Mycetoma is a neglected disease, which is socioeconomically important, and with the possibility of permanent disability in infected persons if not treated early. This is especially true in resource-limited settings such as West Africa, where there is a lack of facilities and skilled personnel to make a definitive laboratory diagnosis. Co...
Article
Full-text available
The steadily growing COVID-19 pandemic is challenging health systems worldwide including Sudan. In Sudan, the first COVID-19 case was reported on 13th March 2020, and up to 11 November 2020 there were 14,401 confirmed cases of which 9,535 cases recovered and the rest 3,750 cases were under treatment. Additionally, 1,116 deaths were reported, indica...
Article
Background: Currently there is a wide knowledge gap in our understanding of mycetoma epidemiological characteristics, including the infection route. Methods: A cross-sectional descriptive epidemiological study was carried out to determine the role of exposure to animals and insects such as ticks in the transmission of eumycetoma in two adjacent...
Article
Mycetoma is a chronic granulomatous disease that significant affects the subcutaneous tissue and deep structures. Mycetoma is caused by certain fungi (eumycetoma) or higher bacteria (actinomycetoma). The clinical presentation is variable and depends on the causative agent. For proper treatment and patient management, an accurate diagnosis of the sp...
Article
Background Mycetoma is a unique neglected tropical disease caused by a substantial number of different fungi or bacteria. Many of the disease's epidemiological characteristics are an enigma. Hence, understanding the spatial geographic distribution of mycetoma may clarify the association between the local environmental indicators, the spatial geogra...
Poster
Full-text available
The Social Sciences for Severe Stigmatising Skin Conditions Project
Poster
Full-text available
5 S project on the social sciences and mycetoma
Article
Background: Mycetoma is a chronic, progressive and destructive inflammatory disease that affects the skin, subcutaneous and other tissues. The objective of this study was to identify all cases of mycetoma diagnosed in three health facilities in Nouakchott, Mauritania during 2016-2018. Methods: This retrospective hospital-based study was conducte...
Technical Report
Full-text available
The Mycetoma Research Centre (MRC) in collaboration with Sennar Ministry of Health and Wad Onsa local community had organised the fifth mission to Wad Onsa Mycetoma Centre (WOMC) in the period 15-18th February 2017.
Article
Abstract Mycetoma is a recognised neglected tropical disease that for a long time has been accorded inadequate attention across the globe. It is a chronic destructive inflammatory disease caused by fungi (eumycetoma) or actinomycetes (actinomycetoma). Mycetoma treatment depends on an accurate and precise diagnosis. The cornerstone for proper diseas...
Technical Report
Full-text available
The Mycetoma Research Centre annual report 2019
Article
Abstract Mycetoma recently had gained international attention and conscious awareness after its inclusion under the WHO/NTD list in 2016. The journey to achieve that was both long, challenging as well as it was exciting and hard. In this article, the milestones and various events that took place in this journey were documented and highlighted.
Article
Species of the genus Microascus are uncommon agents of human diseases despite their ubiquitous presence in the environment. In this communication, the first case of white grain eumycetoma caused by the fungus Microascus gracilis is reported. The patient was initially misdiagnosed as having actinomycetoma based on the grains morphological and cytolo...
Article
In this communication, the Mycetoma Research Center (MRC), University of Khartoum, WHO Collaborating Center on Mycetoma, shares its experience in field surgery for mycetoma. The surgery was conducted in two mycetoma-endemic villages in Sennar and the White Nile States in collaboration with local health authorities, local community leaders, activist...
Article
Full-text available
Mycetoma is a chronic disease caused either by fungi (eumycetoma) or bacteria (actinomycetoma). Treatment remains suboptimal and based on personal clinical experience. Recently, the Mycetoma Research Centre (MRC), a WHO Collaborating Centre on mycetoma, began the first-ever double-blind clinical trial. Here, we report the challenges and barriers fa...
Article
Full-text available
Mycetoma is a chronic subcutaneous granulomatous disease of the soft tissue and extremities. Herein we report four cases of mycetoma caused by different agents, two caused by Madurella mycetomatis, with Actinomadura madurae and Streptomyces somaliensis affecting the others. These lesions originated at different sites but eventually spread to the in...
Article
Abstract Mycetoma is a chronic granulomatous inflammatory disease that is caused either by fungi (eumycetoma) or bacteria (actinomycetoma). The latter is caused by various actinomycetes of the genera Nocardia, Streptomyces and Actinomadura. They have different geographical distributions within mycetoma-endemic regions. In parts of Latin America, No...
Article
Background Eumycetoma is a chronic subcutaneous granulomatous disease that is endemic in Sudan and other countries. It can be caused by eight different fungal orders. The gold standard diagnostic test is culture, however, culture-independent methods such as imaging, histopathological and molecular techniques can support diagnosis, especially in cas...
Article
Full-text available
Abstract Background Eumycetoma is a chronic subcutaneous granulomatous disease that is endemic in Sudan and other countries. It can be caused by eight different fungal orders. The gold standard diagnostic test is culture, however, culture-independent methods such as imaging, histopathological and molecular techniques can support diagnosis, especial...
Article
Mycetoma is a chronic granulomatous inflammatory disease that is caused either by fungi (eumycetoma) or bacteria (actinomycetoma). The latter is caused by various actinomycetes of the genera Nocardia, Streptomyces and Actinomadura. They have different geographical distributions within mycetoma-endemic regions. In parts of Latin America, Nocardia sp...
Article
Mycetoma is a neglected tropical disease that causes tremendous suffering and misery to affected patients. In Sudanese rural communities, many patients hide their lesions, especially those located in the perineal, scrotal, inguinal and genital regions, and they regard them as sources of social stigma. We report the case of a 45-year-old male from n...
Article
In this communication, we report on the first-ever patient presenting with 17 lesions of Madurella mycetomatis eumycetoma in different parts of the body. The reported patient is a 15-y-old female who presented to the Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan, in 2017 with recurrent back and anterior abdominal wall eumycetoma...
Article
Full-text available
Mycetoma is a localized, chronic, granulomatous disease that can be caused by fungi (eumycetoma) or bacteria (actinomycetoma). Of the 70 different causative agents implicated in mycetoma worldwide, Actinomadura madurae is the only one that causes multiple cases on all continents. Recently, new Actinomadura species were described as causative agents...