Buruli-Ulcer Induced Disability in Ghana: A Study at Apromase in the Ashanti Region

Abstract

Objectives. To describe trends and category of disabilities caused by Buruli ulcer disease. Design. This retrospective study was set up to quantify information on the disability trends caused by Buruli ulcer (BU) using data on patients attending BU and chronic ulcer clinics from 2004 to 2009, at Global Evangelical Mission Hospital, Apromase. Methods. Data was retrieved from the WHO BU1 form, case registry book, surgical theatre register, and BU patients' records book of the hospital. Disability was measured as the incapability of patients to perform one or more daily activities due to his/her state of BU disease before treatment. Results. A total of 336 positive BU cases comprising 181 males (53.9%) were recorded of which 113 (33.6%) cases of disabilities were identified. A mean age of 52.5 (±1.32) years was recorded. For the trend of disabilities, the year 2009 recorded the highest (N = 34, 31.0%). The lesions were mostly located at the lower limbs (N = 65, 57.5%) region of the patients. Lesions with diameter >15 cm were the major (59.3%) category of lesions. Conclusion. Trend of disability reveals proportional increase over the years from 2004 to 2009. Contracture at the knee and ankle joints was the commonest disability recorded.

Contribution of the Community Health Volunteers in the Control of Buruli Ulcer in Bénin

“…Usually BU begins as a painless nodule, plaque or edema, ultimately developing into an ulcer. The high number of patients presenting with ulcers in an advanced stage is a major problem because treatment of advanced disease is complex and frequently has long-term disabilities as a consequence [5] , [6] . Late presentation to health care facilities is common and is influenced by practical matters such as travel costs, visits to traditional healers and the patient's perception of illness [7] , [8] .…”

Mycobacterium ulcerans Disease of the Face: The Fate of the Victims

“…BU is found in many places around the world, often near water bodies but the exact mode of transmission of the germ from the environment to humans is not known [23]. However, it appears that different modes of transmission occur in different geographic areas and during the rainy season in Africa and exposure may occur in muddy farming fields [1,24,25].…”

“…The available environment, rather than from person to person [6,19,27]. The disease is usually found in communities near rivers, swamps and wetlands [6,23]. The recent identification of M. ulcerans in certain water insects has raised the possibility of mechanical transmission of the infection [5,6,19].…”

“…Interventions to prevent disability should start before excision and continue after excision and skin grafting in order to prevent soft tissue contractures. Prevention of disability and rehabilitation are only possible with the active participation of those affected by BU, their families, the community, and the health-care team [23]. The use of laser therapy in the treatment of facial scars has been reported [42]; however, none of the patients who have developed scars as a result of the disease as shown in the figures above has undergone laser therapy.…”

“…Large ulcers or extensive edematous lesions generally require excision followed by skin grafting [23,30]. Ulceration that extends to the eyelid and base of the nose are treated by four surgical excisions, daily wound dressings and skin grafts.…”