A neglected tropical disease
By Geraldine Ambe
Agent host interaction
Buruli ulcers known as bairnsdale ulcer, daintree
ulcer, mossman ulcer, searl ulcer, necrotizing
disease of soft tissue.
Cause mycobacterium ulcerans.
Rapid emergency of disease in most parts of
WHO tools for better Bu control and
Reported in over 30 countries.
Largest numbers in Zaire, Congo, Cameroon,
Nigeria, Benin, Ghana, Togo, Liberia, Ivory
coast, Australia, southeast Asia.
BARRIER TO DETERMINE EXACT
Lack of access to health care
Multiple clinical presentation of disease
Limited knowledge of healthcare workers
Limited public knowledge about the disease
Occurs near water bodies, rivers, lakes, swams,
ponds( activities farming)
Most afflicted children age 15years and under
90% of lesions on limbs
60% lower limbs.
MORTALITY AND MORBIDITY
Disease has low mortality rate
High morbidity and socioeconomic burden
Countries Population 2002 2003
Benin 6,097,000 565 724
Cameroon 15,481,00 132 230
Cote d’ivoire 17,109,00 0 1235
Ghana 20,212,00 853 739
Togo 4,629,00 96 56
Guinee 8,185,820 328 157
M Ulcerans slow growing mycobacteria
causative agent of BU
An environmental pathogen, isolated from
biofilms and small aquatic animals of slow
moving, or stagnant bodies of water.
Suggested transmission, mosquitoes bites.
Signs and Symptoms
BU starts as a painless, mobile swelling in the
Large area of induration
No pain and fever
Incubation period few weeks to months.
BU STARTS AS A NODULE
Retrieved from http://www.who.int/buruli/photos/nonulcerative/en/index.html
Buruli ulcer can extend to 15% of a person's skin surface and
may destroy nerves and blood vessels. Metastatic bone lesions
An edematous Buruli ulcer in a 9-year-old Togolese girl (see
Media File 3). Courtesy of Wayne M. Meyers, MD.
Togolese girl in Media File 2 taken 5 years after the Buruli
ulcer had been excised and repaired with autologous split-
skin graft by G.B. Priuli, MD. Courtesy of Wayne M. Meyers,
Rifampin / Streptomycin
Social and Cultural Aspects
Loss of productivity
Cost of treatment
Control and Surveillance
Training health care professionals
Laboratory case confirmation
Advance health facilities
Monitor, evaluate control activities.
Improve case finding.
Improve case management
Improve Channels of communication.
Increase Research studies on Buruli ulcers.
Members of heavy burden communities
Medical health care professionals, (Doctors,
nurses, laboratory workers, other health
community field workers
University medical student and nursing school
Centers for disease control and prevention
World Health Organization (WHO)
Doctors without Borders.
Buruli ulcer control programme Headquaters in
ADVOCATES FOR GLOBAL
Benbow, M.,E. Williamson, H., et al (2008). A large –scale field study on
aquatic invertebrates associated with buruli ulcer disease: Are biting water
bugs likely vectors? Emerging infectious diseases. Retrieved October
20th,2009 from website http://www.cdc.gov/EID/content/14/8/1247.htm.
Wagner, T., Benbow, M.E., et al (2008). A landscape based model for
predicting Mycobacterium ulcerans infections: Buruli ulcer disease presence in
Benin, West Africa. EcoHealth.
Guidelines for controlling buruli ulcers in the African Region(2006) World
health organization Retrieved October 20th, 2009 from website