PhD defence S. (Shereen) Omerelfarouk Abdalgaffar Osman

Below is a brief summary of the dissertation:

Mycetoma can be caused by bacteria (actinomycetoma) and fungi (eumycetoma). To initiate the correct therapy, actinomycetoma must be differentiated from eumycetoma. In many endemic regions, this is not possible in the field. Therefore, patients are empirically treated for both actinomycetoma and eumycetoma simultaneously.

Currently, the standard treatment for actinomycetoma involves a lengthy course of antibiotics. The treatment duration ranges from 5 weeks t o 2 years. The most frequently used combination is trimethoprim-sulfamethoxazole and amikacin, of which the latter can only be used for a limited time due to ototoxicity. In general, cure rates of greater than 95% were achieved. 
Eumycetoma is treated with a combination of antifungal therapy and surgery. The currently recommended therapy consists of six months of itraconazole, surgical removal of the lesion, and then at least six months of treatment. Under clinical trial conditions, this results in an 85% cure rate. However, a cure rate of 68% is achieved in routine care. 
When the etiology is unknown, patients are often treated with a combination of itraconazole, trimethoprim sulfamethoxazole, and amikacin; the treatment response is monitored over time. Since patients need to finance this costly treatment themselves, non-adherence due to a lack of finances may occur and lead to higher risks of drug-drug interaction and resistance. 
Natural products remain a "highly promising reservoir" for new antiparasitic drugs, especially when combined with modern technologies. 
This thesis demonstrates that it is possible to identify compounds, including essential oils and their semisynthetic derivatives, with dual activity against both actinomycetoma and eumycetoma- causative agents.
These findings represent a significant step toward developing broad-spectrum, accessible treatment options for mycetoma, thereby addressing a critical gap in current therapeutic strategies.