Abstract
Aims. This retrospective study was to identify some challenges in the treatment of Buruli ulcer (BU) and present a proposed treatment regime. Materials and Methods. Information from patients medical records, hospital database, and follow-up findings on BU treatment procedures from 1994 to 1998 and from 2004 to 2007 at three research sites in Ghana were reviewed to determine the treatment challenges encountered. Data needed were recorded and analyzed, and results presented using SPSS version 17.0. Results. A total of 489 BU patients information was selected for the study. A majority (56.90%, n = 278) of the patients were children (0–14 years), with a mean age of 12.8 years. Significant challenges in BU treatment in Ghana identified included sequelae (P = 0.041 ), delayed treatment (P = 0.012 ), and high treatment cost (P = 0.044 ). Duration of hospital stay was clearly correlated with the time spent at home prior to admission; spearman's rank correlation coefficient was 0.72 (95% CI 0.42–0.87). Conclusion. Delays in seeking treatment among BU patients were the main factor which resulted in most of the other factors contributing to the challenges in treatment. A combination of psychosocial and biomedical approach was proposed as holistic method to alleviate the challenges in BU treatment.
Highlights
Buruli ulcer (BU), the Mycobacterium ulcerans skin ulcer, known as Bairnsdale ulcer, Daintree ulcer, Mossman ulcer, Kumusi ulcer, Tontokrom ulcer, and Searles’ ulcer, is a chronic, indolent, and necrotizing disease of the skin and soft tissue caused by Mycobacterium ulcerans (MU), which usually begins as a painless nodule or papule and may progress to massive skin ulceration [1,2,3]
MU infection was first reported in Bairnsdale, southeast Australia in 1948 [4] and later named Buruli ulcer in Uganda [5]
Similar surgical interventions were performed in the study of Agbenorku in Ghana in the head and neck region (HNR), for patients who delayed in seeking medical treatment
Summary
Buruli ulcer (BU), the Mycobacterium ulcerans skin ulcer, known as Bairnsdale ulcer, Daintree ulcer, Mossman ulcer, Kumusi ulcer, Tontokrom ulcer, and Searles’ ulcer, is a chronic, indolent, and necrotizing disease of the skin and soft tissue caused by Mycobacterium ulcerans (MU), which usually begins as a painless nodule or papule and may progress to massive skin ulceration [1,2,3]. Subsequent complications may include contracture deformities, leading to loss or limitations in function and even amputations. Buruli Ulcer Initiative” by the World Health Organization (WHO) in early 2008 [1]. MU infection was first reported in Bairnsdale, southeast Australia in 1948 [4] and later named Buruli ulcer in Uganda [5]. BU mainly affects individuals in humid, rural, tropical regions with limited access to medical care. BU frequently occurs near water bodies—slow flowing rivers, ponds, swamps, and lakes; cases have occurred following flooding
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