Buruli Ulcer: Treatment Challenges at Three Centres in Ghana

Agbenorku, Pius; Donwi, Isaac K.; Kuadzi, Pawson; Saunderson, Paul

doi:10.1155/2012/371915

Cited by 13 publications

(25 citation statements)

References 16 publications

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“…Uncertainty about where to seek treatment and lack of knowledge about BU before they were diagnosed were also mentioned. Indeed, early diagnosis and treatment is associated with better outcome [13,14]. Several people in the focus group discussions mentioned that they were scared because their urine changed colour during treatment, whilst this is invariably the case in individuals taking rifampicin [33].…”

Section: Discussionmentioning

confidence: 99%

Former Buruli Ulcer Patients’ Experiences and Wishes May Serve as a Guide to Further Improve Buruli Ulcer Management

et al. 2016

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BackgroundBuruli ulcer (BU), caused by Mycobacterium ulcerans, is a neglected tropical disease frequently leading to permanent disabilities. The ulcers are treated with rifampicin and streptomycin, wound care and, if necessary surgical intervention. Professionals have exclusively shaped the research agenda concerning management and control, while patients’ perspective on priorities and preferences have not explicitly been explored or addressed.Methodology/Principal findingsTo get insight into patient perception of the management and control of Buruli ulcer a mixed methods research design was applied with a questionnaire and focus group discussions among former BU patients. Data collection was obtained in collaboration with a local team of native speakers in Ghana. A questionnaire was completed by 60 former patients and four focus group discussions were conducted with eight participants per group. Former patients positively evaluated both the effectiveness of the treatment and the financial contribution received for the travel costs to the hospitals. Pain experienced during treatment procedures, in particular wound care and the streptomycin injections, and the side-effects of the treatment were negatively evaluated. Former patients considered the development of preventive measures and knowledge on the transmission as priorities. Additionally, former patients asked for improved accessibility of health services, counselling and economic support.ConclusionsThese findings can be used to improve clinical management and to guide the international research agenda.

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Section: Discussionmentioning

confidence: 99%

Former Buruli Ulcer Patients’ Experiences and Wishes May Serve as a Guide to Further Improve Buruli Ulcer Management

et al. 2016

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“…Since 2004, treatment of patients for eight weeks with the antibiotics rifampicin and streptomycin is recommended as standard therapy by the World Health Organization (WHO) [ 6 ]. Even though the use of antibiotics has reduced recurrence rates to less than 2% [ 7 – 9 ], patients are often left with scars and lifelong disabilities [ 10 ]. A vaccine against BU would therefore be of high value to prevent and treat the disease [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Use of Recombinant Virus Replicon Particles for Vaccination against Mycobacterium ulcerans Disease

Bolz

Kerber²,

Zimmer³

et al. 2015

PLoS Negl Trop Dis

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Buruli ulcer, caused by infection with Mycobacterium ulcerans, is a necrotizing disease of the skin and subcutaneous tissue, which is most prevalent in rural regions of West African countries. The majority of clinical presentations seen in patients are ulcers on limbs that can be treated by eight weeks of antibiotic therapy. Nevertheless, scarring and permanent disabilities occur frequently and Buruli ulcer still causes high morbidity. A vaccine against the disease is so far not available but would be of great benefit if used for prophylaxis as well as therapy. In the present study, vesicular stomatitis virus-based RNA replicon particles encoding the M. ulcerans proteins MUL2232 and MUL3720 were generated and the expression of the recombinant antigens characterized in vitro. Immunisation of mice with the recombinant replicon particles elicited antibodies that reacted with the endogenous antigens of M. ulcerans cells. A prime-boost immunization regimen with MUL2232-recombinant replicon particles and recombinant MUL2232 protein induced a strong immune response but only slightly reduced bacterial multiplication in a mouse model of M. ulcerans infection. We conclude that a monovalent vaccine based on the MUL2232 antigen will probably not sufficiently control M. ulcerans infection in humans.

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“…Contractures (Figure 3) are treated by surgical release and deformities are corrected by reconstructive surgery. [101][102][103] However, the option of surgery may not be readily available or affordable in endemic countries.…”

Section: The Role Of Surgery and Wound Carementioning

confidence: 99%

Buruli ulcer: wound care and rehabilitation

Frimpong¹,

Duah²,

Wansbrough‐Jones³

et al. 2016

CWCMR

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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 limited. 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: Treatment Challenges at Three Centres in Ghana

Cited by 13 publications

References 16 publications

Former Buruli Ulcer Patients’ Experiences and Wishes May Serve as a Guide to Further Improve Buruli Ulcer Management

Former Buruli Ulcer Patients’ Experiences and Wishes May Serve as a Guide to Further Improve Buruli Ulcer Management

Use of Recombinant Virus Replicon Particles for Vaccination against Mycobacterium ulcerans Disease

Buruli ulcer: wound care and rehabilitation

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