Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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Diagnostics 2019, 9(4), 204; https://doi.org/10.3390/diagnostics9040204
Buruli ulcer – community information sheet (October 2018)
Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Buruli ulcer is a disease caused by the environmental pathogen Mycobacterium ulcerans that affects skin and soft tissue. It was first described in Australia in 1948 and has been reported in several sub-Saharan African countries since the late 19th century. The disease mainly affects children in rura...l areas and causes lesions and ulcers that can lead to disability if not treated. Recent research has identified a toxin produced by M. ulcerans that may be responsible for the disease's pathogenesis. Efforts are ongoing to understand transmission and develop effective control strategies, including through training of medical professionals and increased detection and treatment of cases.
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A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists working on this disease, the manual details the exac...t procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
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Manuel destiné au personnel de santé. Le présent manuel est un guide spécialisé sur les techniques et les méthodes de laboratoire à utiliser pour le diagnostic de l’ulcère de Buruli, une maladie provoquée par Mycobacterium ulcerans. Destiné aux techniciens et aux scientifi ques de labora...toire travaillant sur cette maladie, le présent manuel décrit les méthodes exactes à mettre en oeuvre pour réaliser un certain nombre de tests diagnostiques. Les procédures recommandées, utilisables dans l’ensemble du système de santé, sont adaptées aux services périphériques, des districts et centraux et ce, conformément aux ressources, compétences et matériel variables que l’on trouve classiquement dans les pays où l’ulcère de Buruli est endémique.
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A review of prospects for existing antibiotics ad new therapeutics
Buruli ulcer is a chronic, progressive skin disease caused by infection with Mycobacterium ulcerans. It is currently considered to be one of the neglected tropical diseases; less common than tuberculosis but more common than leprosy. The initial lesion is a painless subcutaneous nodule, usually less... than 5 cm diameter and adherent to skin. The nodule typically breaks down centrally after days to weeks forming an ulcer with undermined edges. Thus, the external appearance of the ulcer underestimates the true size of the affected area. The patient remains well and there is no pain unless secondary bacterial infection occurs. Other forms of M. ulcerans disease include a firm plaque lesions that behaves in the same way as the nodule or an oedematous lesion that is more aggressive and extends rapidly resulting in a very large ulcer.
Any age group can be affected by Buruli ulcer diseases, but the incidence peaks at 5 to 15 years. Ulcers are most frequently on the limbs but can be on the trunk or head, sometimes with catastrophic consequences such as loss of sight or loss of breast or genital tissue. Healing close to a joint can result in contracture, and sometimes there is so much tissue destruction on a limb that amputation is unavoidable. Occasionally osteomyelitis occurs in bone adjacent to a skin lesion but involvement of other organs is rare. Disseminated disease with HIV has been reported.
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Guidance for health workers
recommandations à l’intention des agents de santé
Buruli ulcer mostly affects children. This comic is aimed at giving them a better knowledge of the disease.
L'ulcère de Buruli touche surtout les enfants. Cette bande dessinée vise à leur donner une meilleure connaissance de la maladie.
This video "Buruli Ulcer Disease: Buruli Plaque" is part of a multimedia-based module by Richard Phillips, Stephen Sarfo, Emmanuel Adu, Veronica Owusu-Afriyie, and Cary Engleberg (University of Michigan). This video addresses the question of: What is the usual presentation and course of Buruli ulcer... disease?
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A guide for field health workers
This video "Buruli Ulcer Disease: Buruli Odema" is part of a multimedia-based module by Richard Phillips, Stephen Sarfo, Emmanuel Adu, Veronica Owusu-Afriyie, and Cary Engleberg (University of Michigan). This video addresses the question of: What is the usual presentation and course of Buruli ulcer ...disease?
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/// ULCÈRE DE BURULIIV
Les objectifs de ce document sont de contribuer à ce que l’ulcère de Buruli (infection à Mycobacterium ulcerans) soit mieux reconnu et d’inciter à intensifier les efforts pour détecter les cas à un stade précoce de l’infection. Aujourd’hui, les malades peuvent... être guéris par des antibiotiques s’ils sont diagnostiqués suffisamment tôt, ce qui permet d’éviter des souffrances et des incapacités inutiles. Nous espérons que tous les utilisateurs de ce document participeront à la réalisation de ces objectifs.
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Dermatologic Clinics Volume 29, Issue 1p1-8January 2011
This is a series of videos about Buruli ulcer disease from Kwame Nkrumah University of Science and Technology. These videos were created Richard Phillips, Stephen Sarfo, Emmanuel Adu, Veronica Owusu-Afriyie, and Cary Engleberg (University of Michigan). The complete learning module is available throu...gh the African Health OER Network at: http://open.umich.edu/education/med/oernetwork/med/internal/buruli-ulcer/2009.
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