Surgical management of Buruli ulcer disease: A four year experience from four endemic districts in Ghana

Adu, Emmanuel J. K.; Ampadu, Edwin; Acheampong, Desmond Omane

doi:10.4314/gmj.v45i1.68914

Cited by 21 publications

(27 citation statements)

References 12 publications

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“…Of the 259 active cases, 62 (23.9%) were diagnosed with joint functional limitations, similar to previous findings in the same area [19], and in other African endemic regions [6], [12]. The general finding of limbs being most affected was confirmed in this study [2], [11]–[13], [23], [24].…”

Section: Discussionsupporting

confidence: 90%

Burden of Mycobacterium ulcerans Disease (Buruli Ulcer) and the Underreporting Ratio in the Territory of Songololo, Democratic Republic of Congo

et al. 2013

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BackgroundCutaneous infection by Mycobacterium ulcerans, also known as Buruli ulcer (BU), represents the third most common mycobacterial disease in the world after tuberculosis and leprosy. Data on the burden of BU disease in the Democratic Republic of Congo are scanty. This study aimed to estimate the prevalence rate and the distribution of BU in the Songololo Territory, and to assess the coverage of the existing hospital-based reporting system.MethodsWe conducted a cross-sectional survey (July–August 2008) using the door-to-door method simultaneously in the two rural health zones (RHZ) of the Songololo Territory (RHZ of Kimpese and Nsona-Mpangu), each containing twenty health areas. Cases were defined clinically as active BU and inactive BU in accordance with WHO-case definitions.ResultsWe detected 775 BU patients (259 active and 516 inactive) in a total population of 237,418 inhabitants. The overall prevalence of BU in Songololo Territory was 3.3/1000 inhabitants, varying from 0 to 27.5/1000 between health areas. Of the 259 patients with active BU, 18 (7%) had been reported in the hospital-based reporting system at Kimpese in the 6–8 months prior to the survey.ConclusionThe survey demonstrated a huge variation of prevalence between health areas in Songololo Territory and gross underreporting of BU cases in the hospital-based reporting system. Data obtained may contribute to better targeted and improved BU control interventions, and serve as a baseline for future assessments of the control program.

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Section: Discussionsupporting

confidence: 90%

Burden of Mycobacterium ulcerans Disease (Buruli Ulcer) and the Underreporting Ratio in the Territory of Songololo, Democratic Republic of Congo

et al. 2013

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“…The hot weather conditions that are frequently experienced in most African countries encourage farmers to wear less protective clothes during farming to work efficiently. This behavior results in long periods of skin exposure which is likely to facilitate infection, which is evident by different studies that majority of BU lesions are located on lower limbs than on abdomen 13,35,39–41. In addition, exposed BU lesions could also serve as a source of infection as has been hypothesized that humans with large active ulcerative BU lesions could shed off the bacteria into the environment in the course of their daily activities 39…”

Section: Discussionmentioning

confidence: 99%

Environmental and Behavioral Drivers of Buruli Ulcer Disease in Selected Communities Along the Densu River Basin of Ghana: A Case-Control Study

Aboagye

Asare

Otchere

et al. 2017

The American Society of Tropical Medicine and Hygiene

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The exact route of transmission of Mycobacterium ulcerans (MU) (causative agent of Buruli ulcer [BU]), risk factors, and reservoir hosts are not clearly known, although it has been identified as an environmental pathogen. This study assessed potential environmental and behavioral risk factors that influence BU infections. We conducted a case-control study where cases were matched by their demographic characteristics and place of residence. A structured questionnaire was administered to solicit information on the environmental and behavioral factors of participants that may expose them to infection. A total of 176 cases and 176 controls were enrolled into the study. Multivariate conditional logistic regression analysis identified farming in swampy areas (odds ratio [OR] = 4.10, 95% confidence interval [CI] = 3.82–7.18), farming while wearing short clothing (OR = 1,734.1, 95% CI = 68.1–44,120.9), insect bite (OR = 988.3, 95% CI = 31.4–31,115.6), and application of leaves on wounds (OR = 6.23, 95% CI = 4.74–18.11) as potential risk factors. Farming in long clothing (OR = 0.000, 95% CI = 0.00–0.14), washing wound with water and soap (OR = 0.37, 95% CI = 0.29–0.98), and application of adhesive bandage on wounds (OR = 0.31, 95% CI = 0.15–0.82) were found to be protective against BU infection. In the absence of the exact MU transmission mechanisms, education of public in BU-endemic zones on the use of protective clothing during farming activities to limit exposure of the skin and proper wound care management would be essential in the fight against BU.

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“…BU affects individuals of all ages [15], [34] but in the African endemic regions most patients are children [9], [44]. However, when adjusting for the population age distribution, studies in Benin [45] and in Australia [46] showed that 75 to 79 year olds or the ≥74 olds, respectively, have the highest risk of contracting BU.…”

Section: Discussionmentioning

confidence: 99%

“…In 2004, the WHO introduced the use of the combination of streptomycin and rifampicin given daily for 8 weeks as treatment [14]. However, surgery and wound management remain critical aspects of BU care [15], [16].…”

Section: Introductionmentioning

confidence: 99%

Geographic Distribution, Age Pattern and Sites of Lesions in a Cohort of Buruli Ulcer Patients from the Mapé Basin of Cameroon

et al. 2013

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Buruli ulcer (BU), a neglected tropical disease of the skin, caused by Mycobacterium ulcerans, occurs most frequently in children in West Africa. Risk factors for BU include proximity to slow flowing water, poor wound care and not wearing protective clothing. Man-made alterations of the environment have been suggested to lead to increased BU incidence. M. ulcerans DNA has been detected in the environment, water bugs and recently also in mosquitoes. Despite these findings, the mode of transmission of BU remains poorly understood and both transmission by insects or direct inoculation from contaminated environment have been suggested. Here, we investigated the BU epidemiology in the Mapé basin of Cameroon where the damming of the Mapé River since 1988 is believed to have increased the incidence of BU. Through a house-by-house survey in spring 2010, which also examined the local population for leprosy and yaws, and continued surveillance thereafter, we identified, till June 2012, altogether 88 RT-PCR positive cases of BU. We found that the age adjusted cumulative incidence of BU was highest in young teenagers and in individuals above the age of 50 and that very young children (<5) were underrepresented among cases. BU lesions clustered around the ankles and at the back of the elbows. This pattern neither matches any of the published mosquito biting site patterns, nor the published distribution of small skin injuries in children, where lesions on the knees are much more frequent. The option of multiple modes of transmission should thus be considered. Analyzing the geographic distribution of cases in the Mapé Dam area revealed a closer association with the Mbam River than with the artificial lake.

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Surgical management of Buruli ulcer disease: A four year experience from four endemic districts in Ghana

Cited by 21 publications

References 12 publications

Burden of Mycobacterium ulcerans Disease (Buruli Ulcer) and the Underreporting Ratio in the Territory of Songololo, Democratic Republic of Congo

Burden of Mycobacterium ulcerans Disease (Buruli Ulcer) and the Underreporting Ratio in the Territory of Songololo, Democratic Republic of Congo

Environmental and Behavioral Drivers of Buruli Ulcer Disease in Selected Communities Along the Densu River Basin of Ghana: A Case-Control Study

Geographic Distribution, Age Pattern and Sites of Lesions in a Cohort of Buruli Ulcer Patients from the Mapé Basin of Cameroon

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