Seasonal Patterns of Buruli Ulcer Incidence, Central Africa, 2002–2012

Landier, Jordi; Magny, Guillaume Constantin de; Garchitorena, Andrés; Guégan, Jean‐François; Gaudart, Jean; Marsollier, Laurent; Gall, Philippe; Giles‐Vernick, Tamara; Eyangoh, Sara; Fontanet, Arnaud; Texier, Gaétan

doi:10.3201/eid2108.141336

Cited by 20 publications

(27 citation statements)

References 12 publications

(19 reference statements)

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“…In Central Africa, it was shown that cases of Buruli ulcer peaked in March, suggesting that the risk is highest during the rainy season (377). In Cameroon, in the Nyong River distance model, the risk of Buruli ulcer decreased when the distance to the river increased, with a dose-response relationship (378).…”

Section: Geography Of Buruli Ulcermentioning

confidence: 99%

“…In Japan, it was proven that there is a dynamic seasonal appearance of M. ulcerans in the environment, which may contribute to the seasonal variation of Buruli ulcer occurrence (108). In Central Africa, it was shown that the cases of Buruli ulcer peaked in March, suggesting that the risk is at its highest during the rainy season (377). In each country of endemicity, there is a distinct geographical distribution, depending on environmental factors.…”

Section: Geography Of Buruli Ulcermentioning

confidence: 99%

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Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans

et al. 2018

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Buruli ulcer is a noncontagious disabling cutaneous and subcutaneous mycobacteriosis reported by 33 countries in Africa, Asia, Oceania, and South America. The causative agent, , derives from by genomic reduction and acquisition of a plasmid-borne, nonribosomal cytotoxin mycolactone, the major virulence factor. -specific sequences have been readily detected in aquatic environments in food chains involving small mammals. Skin contamination combined with any type of puncture, including insect bites, is the most plausible route of transmission, and skin temperature of<30°C significantly correlates with the topography of lesions. After 30 years of emergence and increasing prevalence between 1970 and 2010, mainly in Africa, factors related to ongoing decreasing prevalence in the same countries remain unexplained. Rapid diagnosis, including laboratory confirmation at the point of care, is mandatory in order to reduce delays in effective treatment. Parenteral and potentially toxic streptomycin-rifampin is to be replaced by oral clarithromycin or fluoroquinolone combined with rifampin. In the absence of proven effective primary prevention, avoiding skin contamination by means of clothing can be implemented in areas of endemicity. Buruli ulcer is a prototype of ecosystem pathology, illustrating the impact of human activities on the environment as a source for emerging tropical infectious diseases.

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Section: Geography Of Buruli Ulcermentioning

confidence: 99%

Section: Geography Of Buruli Ulcermentioning

confidence: 99%

Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans

et al. 2018

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“…The disease occurs in very concentrated, small geographic foci within countries, as described in Cameroon and Australia (16,17). Increases in cases have been associated with heavy periods of rainfall in some places (18)(19)(20)(21). In Africa, landscape fragmentation and destruction has been suggested as a risk factor for Buruli ulcer (22).…”

mentioning

confidence: 99%

Global Epidemiology of Buruli Ulcer, 2010–2017, and Analysis of 2014 WHO Programmatic Targets

Omansen¹,

Erbowor-Becksen²,

Yotsu³

et al. 2019

Emerg. Infect. Dis.

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Buruli ulcer is a neglected tropical disease caused by Myocobacterium ulcerans; it manifests as a skin lesion, nodule, or ulcer that can be extensive and disabling. To assess the global burden and the progress on disease control, we analyzed epidemiologic data reported by countries to the World Health Organization during 2010–2017. During this period, 23,206 cases of Buruli ulcer were reported. Globally, cases declined to 2,217 in 2017, but local epidemics seem to arise, such as in Australia and Liberia. In 2013, the World Health Organization formulated 4 programmatic targets for Buruli ulcer that addressed PCR confirmation, occurrence of category III (extensive) lesions and ulcerative lesions, and movement limitation caused by the disease. In 2014, only the movement limitation goal was met, and in 2019, none are met, on a global average. Our findings support discussion on future Buruli ulcer policy and post-2020 programmatic targets.

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“…10, 59 As discussed here, the interplay between deforestation (changes in landscape ecology and topography) and rainfall events (flooding) allow the redistribution of MU in new environments where abiotic and biotic conditions enhance its prevalence and increase contact rates with human hosts. In addition, at the start of the dry season, these lentic habitats become more accessible for a whole range of human activities, such as crab hunting, fishing, bathing and washing clothes.…”

Section: Introductionmentioning

confidence: 98%

Global and local environmental changes as drivers of Buruli ulcer emergence

Combe

Velvin

Morris

et al. 2017

Emerging Microbes & Infections

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Many emerging infectious diseases are caused by generalist pathogens that infect and transmit via multiple host species with multiple dissemination routes, thus confounding the understanding of pathogen transmission pathways from wildlife reservoirs to humans. The emergence of these pathogens in human populations has frequently been associated with global changes, such as socio-economic, climate or biodiversity modifications, by allowing generalist pathogens to invade and persist in new ecological niches, infect new host species, and thus change the nature of transmission pathways. Using the case of Buruli ulcer disease, we review how land-use changes, climatic patterns and biodiversity alterations contribute to disease emergence in many parts of the world. Here we clearly show that Mycobacterium ulcerans is an environmental pathogen characterized by multi-host transmission dynamics and that its infectious pathways to humans rely on the local effects of global environmental changes. We show that the interplay between habitat changes (for example, deforestation and agricultural land-use changes) and climatic patterns (for example, rainfall events), applied in a local context, can lead to abiotic environmental changes and functional changes in local biodiversity that favor the pathogen's prevalence in the environment and may explain disease emergence.

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Seasonal Patterns of Buruli Ulcer Incidence, Central Africa, 2002–2012

Cited by 20 publications

References 12 publications

Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans

Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans

Global Epidemiology of Buruli Ulcer, 2010–2017, and Analysis of 2014 WHO Programmatic Targets

Global and local environmental changes as drivers of Buruli ulcer emergence

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