Mycetoma, a neglected tropical disease, results from bacterial or fungal infections. Symptoms typically begin with swelling under the skin and can progress to deformities in skin and tissues. The disease disproportionately affects poor, rural communities, where involvement in agricultural and pastoral activities increases contact with contaminated soil. Although a 2022 national survey reported that mycetoma is present in virtually every region in Ethiopia, where about a third of the population lives below the poverty line, the exact prevalence and severity of the disease is unknown due to lack of data and access to diagnosis. Since the disease does not heal on its own, raising awareness of mycetoma in Ethiopia and researching treatment options are crucial. Medical professionals and research organizations like the Drugs for Neglected Diseases initiative (DNDi) have made significant efforts to ensure the health of Ethiopians.

Dermatovenerologist Speaks Out

Professor Wendemagegn Enbiale, an influential dermatovenerologist serving on the WHO Strategic and Technical Advisory Group for Neglected Tropical Diseases, has drawn attention to the difficulties in tackling mycetoma in Ethiopia. In an interview with Capital Ethiopia, he explains that relative painlessness in the initial stages of mycetoma and the long journeys to reach dermatology services deter patients from seeking help. Furthermore, the cost of medicine and lack of knowledge of the best course of treatment prevent patients from making a full recovery.

Addressing these challenges, Enbiale speaks on the need to wear shoes to limit exposure to the soil and the symptoms of mycetoma, including wounds that fail to heal and pus containing black, white, yellow or red grains. This educates Ethiopians on preventive measures and enables them to seek medical assistance before the disease worsens, which could ultimately result in amputation. Enbiale has advocated for mycetoma care to be incorporated into Ethiopia’s Health Extension Program and primary health care system, laying the groundwork for a targeted government strategy against mycetoma.

Training Program for Medical Professionals

Medical professionals have strengthened their response to mycetoma in Ethiopia in recent years. The training program arranged by universities and research organizations in 2025 was vital in equipping radiologists and dermatologists from various regions in Ethiopia with the expertise to diagnose mycetoma through ultrasound. Dr. Mustafa Elnour Bahar, consultant radiologist at the University of Khartoum, presented the complexities of mycetoma before teaching participants how to operate the ultrasound machines in a hands-on session, examining 35 patients. This was an important step in empowering Ethiopia’s health care system to diagnose mycetoma swiftly and effectively.

Mycetoma Open Source Project

DNDi, a not-for-profit research organization dedicated to developing new treatments, has initiated numerous projects to help those suffering from mycetoma. Partnering with the University of Sydney and Erasmus University Medical Center, DNDi launched the Mycetoma Open Source Project (MycetOS) in 2018. MycetOS seeks to discover new drug candidates for fungal mycetoma (eumycetoma) through a transparent, collaborative online platform where researchers and scientists can share their ideas and results.

As the development of drugs for neglected tropical diseases is rarely successful in the commercial market, this approach facilitates large-scale and efficient research. In 2025, the evaluation of Series 1 fenarimols determined the potency of the fenarimol analogue EPL-BS1246 against eumycetoma. DNDi’s continual efforts in drug discovery lay the foundation for more effective treatments for mycetoma.

Clinical Trial Promotes Drug Registration

Additionally, DNDi performed a Phase II clinical trial in Sudan examining fosravuconazole and itraconazole for eumycetoma. Fosravuconazole was not superior to itraconazole in the trial, but it offered practical advantages including weekly dosing and fewer drug-interaction concerns. In 2025, DNDi and Eisai initiated an early access cohort protocol in Kassala, Sudan. Partners also finalized a regulatory dossier for submission in Sudan and advanced wider regulatory engagement for fosravuconazole in eumycetoma-endemic regions.

Collecting Data in Ethiopia

To tackle the lack of epidemiological data, DNDi conducted a community-based survey across Afar, Amhara, Southern Nations and Tigray, screening households and referring people with suspected eumycetoma for diagnosis and care. The field surveys concluded in 2025 and are intended to help establish more robust estimates of the disease burden in Ethiopia, informing future prevention, treatment and clinical research.

Looking Ahead

Medical professionals and DNDi have made significant strides in establishing an initial framework for the fight against mycetoma in Ethiopia. Advancements in medical knowledge and growing visibility and community awareness not only encourage patients to seek help earlier, but also improve the quality of care they receive. This solid foundation in mycetoma care promotes more comprehensive prevention and control strategies in the future, offering hope for containing the disease.

– Katy Wong

Katy is based in Hong Kong and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr