Mycobacterium ulcerans Infection (Buruli Ulcer) in Southwest Nigeria

Abstract

Objectives: Buruli Ulcer Disease (BUD) caused by Mycobacterium ulcerans is a severe neglected tropical disease of the skin, which has been reported in over 33 countries globally including Nigeria where the disease was first reported in 1967 and later in 1975. Since these reports, there has been no research on BU in the southwest Nigeria. In this study we assessed the presence of BUD in five states of the southwest Nigeria.Method: This was a community-based, cross-sectional study where BU awareness sessions preceded active search for suspected cases. Questionnaires were administered for participants' demography. Swab and fine needle aspirate specimens from suspected BU lesions were subjected to IS2404-based Nested PCR and Real time (qPCR) techniques to confirm BUD.Results: A total of 256 samples were collected and analyzed between April, 2016 and December, 2018. 157 (61.3%) samples were positive to IS2404 of M. ulcerans. Children below 15 years of age and adults constituted 42 cases (26.8%) and 115 cases (73.2%), respectively. Index BU cases were confirmed in Ekiti 4 (2.5%), Lagos 11 (7.3%), Ondo 16 (10.6%), Osun 61 (38.9%) and the remaining 64 (40.4%) were found in Ogun State. Ogun and Osun States accounted for 79.3% of all confirmed BU cases in this study.Conclusions: Conclusion: BU cases, for the first time, were confirmed in five states of SW Nigeria with two of them (Ogun and Osun States) indicating endemic situation, hence the need for those states to be kept under surveillance as potential BU flash points. On a larger scale, a robust BU awareness program nationwide should be embarked upon by the government and other stakeholders.