Chromoblastomycosis and sporotrichosis, two endemic but neglected fungal infections in Madagascar.

Chromoblastomycosis and sporotrichosis are endemic fungal infections of tropical and subtropical regions, including Madagascar. The causal fungi develop in the soil or on plants and infect humans through wounds, either directly (wounding by the plant, through thorns, for example), or through the contact of an existing wound with contaminated soil. For this reason, the lesions predominantly occur on the limbs, and these fungi principally infect people working outside with bare hands and/or feet. The subcutaneous lesions of chromoblastomycosis are initially nodular, subsequently becoming warty, tumoral, cauliflower-like and pruriginous, which promotes dissemination. The chronic nature of the infection and its progression over long periods lead to highly disabling lesions in essentially rural and agricultural populations. The lesions of sporotrichosis are also nodular, but more ulcerous, and they form an extended chain following the route of the lymph vessels. Pus, squamous or skin biopsy specimens are used for the mycological examination of these mycoses. Treatment depends on the severity and form of the lesions and is based on antifungal drugs sometimes combined with physical methods. There has been no study of these infections for more than two decades in Madagascar, despite the large numbers of cases seen by doctors in all parts of the island. The nature, diversity and distribution of the plants responsible for contamination have not been described in Madagascar. In this review, we described these two endemic mycoses in terms of their epidemiological, mycological, clinical and therapeutic characteristics, focusing particularly on Madagascar, which is one of the leading foci of these two infections worldwide.

Antimicrobial Activity of 23 Endemic Plants in Madagascar

Purpose: To screen the crude methanol extracts obtained from 23 endemic plants in Madagascar for antimicrobial activity. Methods: In order to assess the antimicrobial properties of the extracts; their minimum inhibitory concentrations (MICs) were obtained using the broth microdilution method. The six test pathogenic species used were Bacillus subtilis; Staphylococcus aureus; Escherichia coli; Salmonella typhi; Pseudomonas aeruginosa and Candida albicans. Bioautography agar overlay test and phytochemical screening were also performed on the most active extracts. Results: From the 23 plants tested; 16 of which are used in traditional medicine; Poivrea phaneropetala Combretaceae); Koehneria madagascariensis (Lythraceae) and Rhopalopilia perrieri (Opiliaceae) exhibited the broad spectrum of activity; being active against all the test organisms; while Monoporus clusiifolius (Myrsinaceae) showed the strongest antifungal activity against Candida albicans with a minimal inhibitory concentration of 0.250 mg/ml. Bioautography and phytochemical analysis of the five active extracts against bacterial strains and of one active extract against C. albicans indicate that the active compounds responsible for antimicrobial activity may be mainly flavonoids and/or terpenes. Conclusion: These preliminary results are the first antimicrobial studies on these of some of them in traditional medicine