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Summary: Background: Regional differences in the underlying causes, manifestations and treatment of mucormycosis have been noted in studies covering Europe, Asia and South America. Objectives: To review cases of mucormycosis across the Middle East and North Africa (MENA) region in order to identify epidemiological, treatment and outcome trends in this region. Patients/Methods: Cases of proven or probable invasive mucormycosis from the region were identified from the FungiScope® database and the medical literature. For each case, information on underlying condition, site of infection, pathogenic species, therapeutic intervention, type of antifungal therapy and outcome were analysed. Results: We identified 310 cases of mucormycosis in the MENA region. The number of reported cases increased by decade from 23 before 1990 to 127 in the 2010s. In this region, the most common underlying conditions associated with mucormycosis were diabetes mellitus (49.7%) and conditions associated with immunosuppression (46.5%). The majority of patients received treatment with antifungals (93.5%), with a large proportion treated with both antifungals and surgery (70.6%). Overall mortality rates decreased from 47.8% before 1990 to 32.3% in the 2010s. Conclusions: The number of reported cases of mucormycosis in the MENA region has risen over the past few decades, in line with increases in the number of patients with underlying conditions associated with this infection. Although the majority of patients received treatment with antifungal therapies and/or surgery, the associated mortality rate remains high and there is a clear need for more effective prevention and treatment strategies in the MENA region. [ABSTRACT FROM AUTHOR]

Chemical, biological, radiological, nuclear and explosive (CBRNe) hazards used as agents during conflicts and terrorism are a threat to any civil society, negatively impacting economical, human, political and environmental aspects. When a country is stricken by CBRNe, several related events can significantly debilitate the public health system's assets, placing additional demands on the health-care organization of the country and neighbors. The consequences for the health of a population might be both direct, such as deaths and injuries, and indirect with long-term aftereffects such as disruption of basic health services, damages to infrastructures and lack of medical personnel. This article provides an overview on the multidimensional impact of CBRNe events on the healthcare sector in the Middle East (Afghanistan, Iraq, Lebanon and Syria) and the countries' efforts in setting up the basis for health system recovery. Our main aim is to emphasize that the rebuilding of an effective healthcare system is a long-term process that requires multiple actions and actors, with epidemiological surveillance being the cornerstone. We maintain that reinvesting in effective health monitoring systems is essential to support countries in meeting the health needs of their populations in post-CBRNe events. This is the first necessary step for appropriately allocating resources, driving investment, setting up preventive strategies and decision-making responses. Furthermore, especially when referring to fragile states, acquiring knowledge on the health needs of the threatened population holds a paramount importance for providing preparedness planning and enhancing resilience of the public health system in case of future CBRNe events. [ABSTRACT FROM AUTHOR]

Background: Regional differences in the underlying causes, manifestations and treatment of mucormycosis have been noted in studies covering Europe, Asia and South America., Objectives: To review cases of mucormycosis across the Middle East and North Africa (MENA) region in order to identify epidemiological, treatment and outcome trends in this region., Patients/methods: Cases of proven or probable invasive mucormycosis from the region were identified from the FungiScope ® database and the medical literature. For each case, information on underlying condition, site of infection, pathogenic species, therapeutic intervention, type of antifungal therapy and outcome were analysed., Results: We identified 310 cases of mucormycosis in the MENA region. The number of reported cases increased by decade from 23 before 1990 to 127 in the 2010s. In this region, the most common underlying conditions associated with mucormycosis were diabetes mellitus (49.7%) and conditions associated with immunosuppression (46.5%). The majority of patients received treatment with antifungals (93.5%), with a large proportion treated with both antifungals and surgery (70.6%). Overall mortality rates decreased from 47.8% before 1990 to 32.3% in the 2010s., Conclusions: The number of reported cases of mucormycosis in the MENA region has risen over the past few decades, in line with increases in the number of patients with underlying conditions associated with this infection. Although the majority of patients received treatment with antifungal therapies and/or surgery, the associated mortality rate remains high and there is a clear need for more effective prevention and treatment strategies in the MENA region., (© 2020 Wiley-VCH GmbH.)

Mucormycosis is a devastating, rapidly progressive, life-threatening disease that necessitates urgent intervention particularly in immunocompromised patients. So far, data on invasive mold infections from the Middle East and other developing countries are limited. We present three patients with invasive mucormycosis and document cures and survival in two of the three patients using conventional systemic antifungal therapy combined with wide surgical debridement. [ABSTRACT FROM AUTHOR]