A cross-sectional study of undergraduate pharmacy students’ awareness and knowledge of mycetoma

INTRODUCTION

Mycetoma is a neglected tropical disease of global concern. It is a disease of socioeconomically important that could lead to permanent disability of infected persons if not treated early.^[1] It affects mostly individuals in limited resource settings, such as Nigeria.^[2] It is characterized by large subcutaneous lesions that are often stigmatizing. Despite being curable and preventable, especially in the early stages, it has a high mortality rate and a significant socioeconomic impact.^[3] It is a subcutaneous granulomatous infectious disease^[4,5] that affects the skin.^[6]

Mycetoma is a chronic pus-forming infection of the skin and subcutaneous tissues that affects the lower limbs in more than 80% of cases.^[7] The disease most likely initiates after a minor trauma that inoculates the causative microorganism in the subcutaneous tissue.^[3] Mycetoma organisms possess mechanisms that aid survival in the human host, allowing them to evade immune defenses.^[8,9] Pain is usually not present, but the temperature at the site may rise.

People who are at risk of mycetoma disease include agricultural workers,^[3] and individuals who walk barefoot in dry dusty conditions.^[10,11] Farmers and other people living in rural areas are more commonly affected since the pathogens causing mycetoma are present in soil and water.^[12,13] Males are more frequently affected (sex ratio 3–4:1), with an age ranging between 20 and 40 years.^[10] However, a study has confirmed that females are equally at risk of having mycetoma, just as males.^[14,15] Prevention of mycetoma can be achieved by wearing shoes.

Mycetoma is diagnosed based on clinical presentation and identification of the causative organism, which can be detected by directly examining the grains that are discharged by the sinuses.^[13] The samples can be obtained by fine-needle aspiration or surgical biopsy.^[16] Treatment of mycetoma includes antibiotics or antifungal medicine, depending on whether the disease is caused by bacteria or fungi. Surgery is sometimes needed to cut away the infected tissue.

Mycetoma disease is endemic in Nigeria primarily because the majority of patients seek medical care very late, when there is already bone involvement, resulting in amputations. Poor access to health care and substantial financial costs were barriers to seeking treatment for mycetoma.^[17] Early case detection of mycetoma depends on appropriate public health messaging and community education.^[17] Unfortunately, most healthcare professionals, including community pharmacists, do not have adequate knowledge and skills required for effective management and control of mycetoma.^[18,19] This results in suboptimal pharmacists’ involvement in the design and implementation of effective prevention strategies for mycetoma disease.^[20-22]

This study investigated the pharmacy students’ awareness and knowledge of mycetoma. Findings from this study will buttress the need for incorporating studies of mycetoma into the pharmacy curriculum, since it is believed that short courses and training, research, and advocacy.

MATERIALS AND METHODS

RESULTS

Out of the 600 questionnaires that were given out, only 406 were properly filled out, giving a response rate of 68%. Half 203 (50%) of the respondents were male, the majority (201; 49.5%) were between the ages of 18 and 29, while 209 (51.5%) were in B. Pharm program. See details in Table 1.

More than half (58.48%) of the respondents were aware of mycetoma disease, although only a few (25.06%) had received lectures or training on mycetoma disease. However, the majority (328; 80.59%) will want the study of mycetoma disease to be included in their undergraduate program curriculum.

A majority (336; 82.8%) of the respondents knew that mycetoma is both a fungal and bacterial infection that is contracted from the soil through a cut on the feet or skin, 266 (65.5%), and animal dung, 299 (73.6%). Most (247; 60.8%) knew that it cannot be contracted through sexual intercourse, while 301 (74.1%) knew that it can be spread from one part of the body to another and can lead to disability, 261 (64.3%). Details are as shown in Table 2.

The mean knowledge score of trachoma was 33.3621 ± 17.12. More than half, 260 (64.0%) of the respondents had good knowledge of mycetoma, while 146 (36.0%) had poor knowledge of mycetoma [Figure 1].

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Figure 1:

Respondent’s knowledge of Mycetoma

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Table 3 revealed that the male students and students within the age range of 18–23 had more knowledge of mycetoma compared to their counterparts, though the difference in the knowledge was not statistically significant (p = 0.255 and 0.085, respectively). However, a significant difference in knowledge of mycetoma was observed among students in various years of study. Respondents who were in their 3^rd and ^5th study year had more knowledge of mycetoma when compared to their counterparts (p = 0.004).

DISCUSSION

This study revealed that pharmacy students are aware of mycetoma disease and have good knowledge of mycetoma. This could be due to the awareness programs and campaigns of mycetoma by Non Government Organisations (NGOs) and government agencies. This study agreed with a previous study, which stated that the awareness of some neglected tropical diseases is high due to numerous awareness programs and campaigns.^[23]

The pharmacy students in this study confirmed that they had not obtained any lecture or information on the awareness of mycetoma from their lectures in school. Contrary to the findings of this study, a study conducted in five Asian countries stated that the medical students and non-medical students learned about neglected tropical diseases (NTDs) from their undergraduate study curriculum, buttressing the need for incorporating studies of NTDs into the undergraduate pharmacy curriculum. It is believed that short courses and training, research, advocacy, and sufficient funding are needed to reduce the burden of NTDs.^[17]

The pharmacy students’ year of study was associated with their knowledge of mycetoma disease. The pharmacy students who had spent a longer time in the undergraduate program had more knowledge of mycetoma. This could be attributed to their experience and training in the course of the program, and also their participation in campaigns, symposiums, and organizations such as International Society for Pharmaceutical Outcomes and Research (ISPOR). These ideas are informed by principles such as curriculum integration, active learning, self-regulated learning, and constructivist progression over time.^[24,25]

Studies in low and middle income countries (LMICs) highlight the need to incorporate NTDs into medical education and professional training, with a particular focus on the most prevalent NTDs like mycetoma. Strengthening knowledge in this area will enhance the active participation of key stakeholders in prevention and control initiatives.^[26] With increased awareness and collaboration between the medical and allied health sectors, the effective prevention, control, and elimination targets of NTDs will be achieved.^[17] Equipping pharmacist with adequate knowledge and skills will boost their confidence, increase their involvement in the prevention, and control of neglected tropical diseases and other public health programs.

CONCLUSION

Pharmacy students had good knowledge of mycetoma disease. They will want lectures/studies on mycetoma to be included in their undergraduate pharmacy curriculum. Therefore, policymakers and education regulatory organizations should incorporate studies on mycetoma, identification, diagnosis, management, prevention, and control strategies in the undergraduate pharmacy program curriculum through lectures, seminars, and debates. By embedding mycetoma studies into the pharmacy curriculum, you create a generation of pharmacists who are both technically competent and policy-aware. This raises disease visibility, expands the research base, strengthens advocacy, and makes it easier for policymakers to act – especially in areas like funding, essential medicines inclusion, and integration into primary health care.