Ecology and Transmission of Buruli Ulcer Disease: A Systematic Review

Abstract

Buruli ulcer is a neglected emerging disease that has recently been reported in some countries as the second most frequent mycobacterial disease in humans after tuberculosis. Cases have been reported from at least 32 countries in Africa (mainly west), Australia, Southeast Asia, China, Central and South America, and the Western Pacific. Large lesions often result in scarring, contractual deformities, amputations, and disabilities, and in Africa, most cases of the disease occur in children between the ages of 4-15 years. This environmental mycobacterium, Mycobacterium ulcerans, is found in communities associated with rivers, swamps, wetlands, and human-linked changes in the aquatic environment, particularly those created as a result of environmental disturbance such as deforestation, dam construction, and agriculture. Buruli ulcer disease is often referred to as the ''mysterious disease'' because the mode of transmission remains unclear, although several hypotheses have been proposed. The above review reveals that various routes of transmission may occur, varying amongst epidemiological setting and geographic region, and that there may be some role for living agents as reservoirs and as vectors of M. ulcerans, in particular aquatic insects, adult mosquitoes or other biting arthropods. We discuss traditional and non-traditional methods for indicting the roles of living agents as biologically significant reservoirs and/or vectors of pathogens, and suggest an intellectual framework for establishing criteria for transmission. The application of these criteria to the transmission of M. ulcerans presents a significant challenge.

Elucidation of Macroeconomic Determinants for Prognosis of Buruli Ulcer

“…"Mysterious disease" Buruli Ulcer thus may spread from biting of such aquatic hemiptera insect (common name Water strider, Gerris sp. ), adult mosquitoes, or other arthropod acting as vector to human [19] [20]. From this segment of the results, it might be said that channeling the excreta, minimizing wastemediated contamination, and carrying out regular pest control can control the growth of the spread of this disease.…”

Geospatial Analysis of Buruli Ulcer Prevalence in Anambra North, Anambra State, Nigeria

“…It is one of the most neglected but treatable tropical diseases mostly found in rural areas located near wetlands or rivers [6]. The disease generally begins as a painless subcutaneous nodule (oedema) usually on the limbs (legs and arms) and faces which over a period of 1-9 months breaks down to form a necrotic ulcer with great pains, though other parts of the body can be affected [7].…”

“…Though the mode of transmission of M. ulcerans is not yet known, the spread of the disease has been suggested to be influenced by local environmental factors such as the presence of rivers, lakes and swampy areas, and through exposed wounds [5,6]. It also survives and thrives in temperature range between 28-34°C [6].…”

Buruli ulcer

“…In Australia, infection following contamination of a golf course irrigation system was reported, 3 while many cases elsewhere are related to disruption of the environment, e.g., due to deforestation and building of dams. 4 Possible sources of infection include aquatic insects, mosquitoes and mammals. 2,5,6 Person-to-person transmission is extremely rare.…”

“…2,5,6 Person-to-person transmission is extremely rare. 4 Until the transmission route is better understood or an effective vaccine is developed, it will be difficult to prevent BU.…”