Laboratory confirmation of buruli ulcer cases in ghana, 20082016. Buruli ulcer bmc infectious diseases biomed central. Lesions heal with scarring, which can result in contractures and deformities. There was a significant difference in the age and sex composition, with more males among the younger. Buruli, near the nile river in uganda, where in 1961 the first large number of cases was reported. Figure 2 above shows the pattern of monthly buruli u lcer cases recorded in the ashanti region of ghana between january, 2005 and december, 2011. National buruli ulcer control programme disease control unit korlebu ministry of health p. The analysis revealed that arima 1, 1, 1 was the best model for forecasting buruli ulcer disease. The ga west municipality is an endemic area for buruli ulcer, and we evaluated the bu surveillance system to determine. It mainly affects the skin but can also affect the bone. With fogarty support, scientists have made inroads into understanding this clandestine disease, which crops up near swamps, wetlands, rivers and lakes, and seems tied to humanproduced changes. Enhancing buruli ulcer control in ghana through social.
It is one of the neglected tropical diseases and second commonest disease caused by mycobacterium in ghana and third globally 3, 4. In order to contribute to the improvement of wound management and reduction of healing delay, we initiated a study to gain understanding of the possible routes of infection and also characterised the resistant profiles of gram negative bacteria isolated from the wounds of patients. To estimate the wound treatment cost borne by the buruli ulcer treatment centre of the amasaman government hospital, ghana. Over the last 2 decades, the incidence of buruli ulcer has increased, despite. The economic burden of diseases has become increasingly relevant to policy makers as healthcare expenditure keep rising in the face of limited and competing resources.
Author summary buruli ulcer bu, a necrotizing skin disease caused by. Buruli ulcer is a disease caused by the bacterium mycobacterium ulcerans. Forecasting buruli ulcer disease in ashanti region of ghana. Buruli ulcer disease and its association with land cover in southwestern ghana showing 14 of 19 pages in this article. Buruli ulcer, is a devastating skin disease caused by mycobacterium ulcerans. Since the only effective treatment is excision of the infection and surrounding tissue, early diagnosis and treatment is the only way to reduce the havoc associated with buruli ulcer.
Buruli ulcer is an infectious disease caused by mycobacterium ulcerans. Monthly buruli ulcer case data from 2005 to 2011 was obtained from ashanti regional disease control unit, kumasi and analysed employing arima. Buruli ulcer is currently endemic in benin, cote divoire, ghana, guinea, liberia, nigeria, sierra leone and togo. Buruli ulcers most commonly affect the arms or legs. Since both conditions require wound care and long courses of medications, and the risk for transmission is minimal, it has. Buruli ulcer is a skin disease caused by the bacterium mycobacterium ulcerans. Bu is capable of causing long term disability when left untreated but though thoroughly researched, has limited studies that. Treatment and prevention of mycobacterium ulcerans. Mf assembled the buruli ulcer laboratory dataset at the kumasi centre for collaborative research in tropical medicine ghana and revised the manuscript for important intellectual content. Background we identified secondary infection of buruli ulcer bu wounds as a cause of healing delay. The early stage of the infection is characterised by a painless nodule or area of swelling.
These bacteria are atypical mycobacteria and come from the same family of. Buruli ulcer bu disease is a chronic debilitating skin disease caused by mycobacterium ulcerans1, 2. Health facility cost of buruli ulcer wound treatment in. Mycobacterium ulcerans an overview sciencedirect topics. Mycobacterium ulcerans is the etiologic agent of buruli ulcer in africa and bairnsdale ulcer in australia, an emerging disease involving chronic and necrotizing skin ulcers. How affected households in a ghanaian district cope. Edwin ampadu, the national focal person for bu at the disease control and prevention department of the ghana health service ghs, it is one of the most neglected but treatable tropical diseases. Buruli ulcer bu, a neglected but treatable tropical disease caused by mycobacterium ulcerans, the only known environmental mycobacterium is capable of causing long term disability when left untreated. The first stage of buruli ulcer starts as a firm, nontender nodule. The aim of this paper is to use the grounded theory method to explore the support needs of people living with the consequences of buruli ulcer in an endemic rural community in ghana. There was a significant difference in the age and sex composition, with more males among the younger age groups than females but the converse among adults. Policy makers take the necessary strategic and policy decisions especially where to target interventions based on available evidence including spatial distribution of the disease.
This disease has dramatically emerged in several west african countries, such as ghana, cote divoire, benin, and togo during the last decade. Using data from a national case search survey conducted in ghana during. Health facility cost of buruli ulcer wound treatment in ghana. Infection often leads to ulcers on the arms or legs, which can also destroy skin or soft tissue. Since the ulcer gets bigger with time, early diagnosis and prompt treatment can minimise skin loss.
Chemistry of natural waters and its relation to buruli ulcer in ghana. Buruli ulcer is found in more than 30 tropical, subtropical, and temperate countries. It often affects the skin and sometimes bone, and can lead to permanent disfigurement and longterm disability. Household cost of outpatient treatment of buruli ulcer in ghana. Author summaryburuli ulcer is an ulcerative skin disease caused by mycobacterium ulcerans. In africa, about 48% of those affected are children under 15 years.
A total of 189 buruli ulcer patients from the bomfa sub. Evaluation of buruli ulcer disease surveillance system in the. Buruli ulcer may induce severe disabilities impacting on a persons wellbeing and quality of life. A study conducted in ghana and in benin interviewing health care personnel dealing with the wound management of buruli ulcer patients reported that standard of wound care differed greatly both. Methods we used the grounded theory research approach to explore the experiences of people living with mycobacterium ulcerans in a rural district in ghana and. The ulcer may be larger inside than at the surface of the skin, and can be surrounded by swelling. Buruli ulcer bu was identified about a century ago, and it is generally referred to as a reemerging disease particularly in west africa, including ghana where the prevalence in some villages is higher than tuberculosis. The case search demonstrated widespread disease and gross underreporting compared with the routine reporting system. Buruli ulcer bu cases in seventyfive health facilities in ghana. Primary risk for buruli ulcer in africa is exposure to stagnant water, but the route of transmission is unknown. Importantly, there seemed to be no reliable chemotherapy, leaving wide excisional surgery and grafting as the only effective treatment. At least 33 countries with tropical, subtropical and temperate climates have reported buruli ulcer in africa, south america and western pacific regions. The majority of cases occur in central and western africa.
For example, laboratory tests from victoria, australia, confirmed the disease in several animals, including. Epidemiology of buruli ulcer in amansie west district, ghana. Buruli ulcer in ghana find, read and cite all the research you need on researchgate. Mycobacterium ulcerans is sweeping across subsaharan africa, but little is known about the mode of transmission and its natural reservoirs. Forecasting buruli ulcer disease in ashanti region of. Jul 16, 2014 buruli ulcer bu disease is a chronic debilitating skin disease caused by mycobacteriumulcerans. Buruli ulcer is a skin infection that kills the cells and tissue in an affected area and creates ulcers on the skin. Buruli ulcer mainly occurs in subsaharan africa, western pacific regions and south america. Here, water samples were collected from five communities within ghana in the.
Buruli ulcer is one of the group of infectious diseases classi. Treatment and prevention of mycobacterium ulcerans infection. It is named after a region called buruli, near the nile river in uganda, where in 1961 the first large number of cases were reported. From 20002001, the national buruli ulcer control programme nbucp was established by the ministry of health, ghana, with an objective to minimize the morbidity and disability associated with buruli ulcer disease, collaborate with research centres in diagnosis and case management, and standardized case management with antibiotics, surgery, and. Buruli ulcers scar, maim and bring misery to thousands of victims each year, but the culprit mycobacterium remains frustratingly difficult to understand. Africa tops the list of most affected regions with cote divoire leading the rate with 2,670 patients. Aimed at laboratory technicians and scientists working on this disease, the manual details the exact procedures to follow when performing a range of diagnostic tests.
Buruli ulcer disease and its association with land cover in. The overall crude national prevalence rate of active lesions was 20. We observe random fluctuations with maximum peak in 2006 i. This article presents the first analysis of buruli ulcer at the village level in southwestern ghana, where prevalence rates are among the highest globally, and explores. Geographical distribution of buruli ulcer cases in cote d ivoire, 1978 and 1997 fig. Buruli ulcer is a chronic debilitating disease caused by mycobacterium ulcerans. This paper describes 90 cases of buruli ulcer in amansie west district, ghana.
Occurring mostly in rural tropical regions it is the third most common mycobacterial disease in immunocompetent humans after tuberculosis and leprosy figure 1857. Buruli ulcer disease and its association with land cover. Full text epidemiology and disease burden of buruli ulcer. Though usually not fatal, ulceration can cover up to 15% of the body, with treatment being costly and sometimes painful. One possibility is that the disease is passed to humans from some insects that are found in water. The worst affected age group in this endemic region is mainly children aged 15 years and below. In 2015, 2037 new cases of buruli ulcer were reported globally and 19 of them in the african region. A national search for cases of buruli ulcer in ghana identified 5,619 patients, with 6,332 clinical lesions at various stages.
Distribution of mycobacterium ulcerans in buruli ulcer. Buruli ulcer, an infectious disease caused by mycobacterium ulcerans, is the third most prevalent mycobacteriosis. Ever since mycobacterium ulcerans infection was first described in australia in 1948 1 and later named buruli ulcer in uganda 2, cases have been reported. Buruli ulcer bu, caused by mycobacterium ulcerans infection, is a debilitating. Buruli ulcer is a disease of skin and soft tissue with the potential to leave sufferers. What is buruli ulcer buruli ulcer is a necrotising disease causing tissue death of the skin and underlying tissue buruli ulcer is also called bairnsdale ulcer, searles ulcer, daintree ulcer, and sikbelongasepik what is the cause of buruli ulcer. Currently, bu has been reported in over 30 countries, in the subtropical regions of asia, latin america, the western pacific region and eastern and central. The first page of the pdf of this article appears above. Nov, 2014 buruli ulcer may induce severe disabilities impacting on a persons wellbeing and quality of life.
Evaluation of buruli ulcer disease surveillance system in. Application of geographical information system gis. Pdf on jan 1, 1997, ernesto montoro and others published buruli ulcer in ghana find, read and cite all the research you need on. Buruli ulcer, poverty, and poverty reduction in rural. But the first case of bu was reported in australia in 1948. Trends of buruli ulcer cases in cote d ivoire, 1978 1997 fig. Buruli ulcer, mycobacterium ulcerans, district of zio, district of yoto, togo, risk factor.
Ea provided access to buruli ulcer surveillance data owned by the ghana ministry of health and revised the manuscript for important intellectual content. Persisting social participation restrictions among former. Mar 17, 2014 b uruli ulcer bu is a neglected tropical disease that is increasingly common in australia and has become an important public health issue in rural subsaharan africa in the past 30 years. Cases are generally seen in the tropics, primarily in west africa and australia.
Buruli ulcer bu, is a neglected infectious disease of tropical and subtropical climates caused by mycobacterium ulcerans, the only known environmental mycobacterium and the third commonest mycobacterium after mycobacterium tuberculosis and leprosae. Buruli ulcer bu is one of the most neglected tropical diseases caused by mycobacterium ulcerans. In the past decade, more than 95% of all cases have been reported from africa, with cote divoire, ghana, benin, and cameroon being the four most endemic countries. Pdf wound care in buruli ulcer disease in ghana and benin. Buruli ulcer is caused by bacteria called mycobacterium ulcerans. In ghana, 1999 data indicated that the prevalence rate of the disease in the ga west district was 87. B uruli ulcer bu is a neglected tropical disease that is increasingly common in australia and has become an important public health issue in rural subsaharan africa in the past 30 years. Since the ulcer gets bigger with time, early diagnosis and prompt treatment can. Information about longterm disabilities and participation restrictions is scanty.
The objective of this study was to gain insight into participation restrictions among former buruli ulcer patients in ghana and benin. In 1998, at a special who conference on buruli ulcer held in yamoussoukro, cote divoire, delegates and heads of state of affected countries recognised buruli ulcer as a damaging disease about which little was known. Estimating buruli ulcer prevalence in southwestern ghana. While no proven link exists between human and animal infection, some animals can get the disease. In all countries, at least 70% of all cases are diagnosed in the ulceration stage. Although they are both present in overlapping population groups in west africa, efforts to care for people affected have usually had a single disease focus. Apr 19, 2016 buruli ulcer is a skin infection that kills the cells and tissue in an affected area and creates ulcers on the skin. Bairnsdale ulcer, daintree ulcer, mossman ulcer, searl ulcer, kakerifu ulcer, toro ulcer buruli ulcer is a chronic, indolent, necrotising disease of the skin and soft tissue caused by mycobacterium ulcerans. The toxins made by the bacteria destroy skin cells, small blood vessels and the fat under the skin, which causes ulceration and skin loss. National buruli ulcer control programme ghana home. The 1,048 th buruli ulcer case has been recorded in ghana making it the second most infected region in the world. Africa bears the major brunt of the global buruli ulcer bu burden. The results showed that in general, the trend of buruli ulcer disease peaked during 2006. Buruli ulcer is the third most common mycobacterium disease after tuberculosis and leprosy.
Buruli ulcer buruli ulcer is a disease caused by infection with mycobacterium ulcerans. It is caused by a bacteria and is the third most common bacterial disease after. It is associated with areas where the water is slowflowing or stagnant. Household cost of outpatient treatment of buruli ulcer in. Cases have also been reported from australia, south east asia, and central and south america. This page is setup to help create awareness and advocacy on buruli ulcer in ghana. National buruli ulcer control programme ghana facebook. Searching for causes of buruli ulcers in ghana fogarty. Pdf on jan 1, 1997, ernesto montoro and others published research note. Buruli ulcer, an emerging disease caused by mycobacterium ulcerans. Pdf a national search for cases of buruli ulcer in ghana identified 5619 patients, with 6332 clinical lesions at various stages.