Abstract
Sporotrichosis is a saprozoonotic fungal infection found mostly in tropical and subtropical areas. Few case reports in Madagascar have been published. To document sporotrichosis epidemiology in Madagascar, we conducted a cross-sectional study. During March 2013–June 2017, we recruited from select hospitals in Madagascar patients with chronic cutaneous lesions suggestive of dermatomycosis. Sporotrichosis was diagnosed for 63 (42.5%) of 148 patients. All but 1 patient came from the central highlands, where the prevalence was 0.21 cases/100,000 inhabitants. Frequency was high (64.7%) among patients <18 years of age. Sporotrichosis was diagnosed for 73.8% of patients with arm lesions, 32.3% with leg lesions, and 15.4% with lesions at other sites. Molecular identification identified 53 Sporothrix schenckii isolates. Among the 32 patients who were followed up, response to itraconazole was complete or major for 15 and minor for 17. Overall, endemicity of sporotrichosis in Madagascar was high, concentrated in the highlands.
Highlights
Sporotrichosis is a saprozoonotic fungal infection found mostly in tropical and subtropical areas
The phylogenetic analysis showed that the isolates from patients with sporotrichosis in our study were grouped in the S. schenckii clade, together with clinical strains from other regions of the world (Figure 3; Appendix 2 Figure 2)
We estimated an average annual prevalence in the highlands of 0.21 cases/100,000 inhabitants; 98% of the cases were concentrated in that area
Summary
Sporotrichosis is a saprozoonotic fungal infection found mostly in tropical and subtropical areas. Few case reports in Madagascar have been published. Sporotrichosis was diagnosed for 63 (42.5%) of 148 patients. Endemicity of sporotrichosis in Madagascar was high, concentrated in the highlands. Sporotrichosis is a chronic fungal infection of humans and animals, found mostly in tropical and subtropical regions. Sporotrichosis is a Author affiliations: Centre d’Infectiologie Charles Mérieux, Université d’Antananarivo, Antananarivo, Madagascar Cornet); Unité de Soins de Formation et de Recherche, Centre Hospitalier Universitaire Joseph Raseta Befelatanana, Antananarivo Andrianarison, F.R. Rabenja, L.S. Ramarozatovo); Unité Para-clinique de Formation et de Recherche, Centre Hospitalier Universitaire Joseph Ravoahangy, Antananarivo RESEARCH average annual prevalence and clinical presentation of sporotrichosis in Madagascar, along with patient outcomes. We report the species-level identification, genetic relatedness, and antifungal susceptibility of the clinical isolates
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