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Functional Limitations after Surgical or Antibiotic Treatment for Buruli Ulcer in Benin

Almost half of patients have functional limitations after treatment of Buruli ulcer disease. Antibiotic treatment (along with surgery) was introduced in the National Program for Buruli ulcer in Benin in 2005. The aim of this study was to compare functional limitations in patients who were treated by antibiotics, surgery, or both, using a validated questionnaire. One hundred seventy-nine former patients in Lalo, Benin were retrieved and interviewed in their village. Hospital records were used to gather data about size of lesion at presentation and treatment provided. No significant differences in resulting functional limitations were found between the different treatments. Larger lesions (> 15 cm cross-sectional diameter) at presentation; lesions on a joint, muscular atrophy, and amputation were all associated with a higher risk for functional limitations. Advantages of antibiotic treatment may involve other domains, like costs of treatment or a change in help-seeking behavior.

Received September 8, 2008. Accepted for publication April 15, 2009.

Acknowledgments: We thank Bienvenu Gbemadon and Elie Hounsah for their assistance with data collection.

Financial support: This study was funded by the EU-FP6 (contract INCO-CT-2005-015476–project BURULICO), the Anna Foundation, and the AXA Insurance Company. Y. Stienstra received a grant from the NWO (Dutch Organization for Scientific Research).

^* Address correspondence to Ymkje Stienstra, Departments of Internal Medicine, Division of Infectious Diseases. Current position at Department of Internal Medicine, Division of Infectious Disease, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, Building F4-222, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. E-mail: y.stienstra{at}amc.uva.nl

Authors’ addresses: Yves Barogui, Department of Internal Medicine, Division of Infectious Disease, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, Building F4-222, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. R. Christian Johnson, Ghislain Sopoh, and Ange Dossou, Programme National Lutte contre la Lèpre et l’Ulcère de Buruli, Ministère de la Santé, Cotonou, République du Bénin. Tjip S. van der Werf, Departments of Internal Medicine and Pulmonary Diseases and Tuberculosis, Infectious Diseases and Tuberculosis Service, University Medical Centre Groningen, University of Groningen, PO Box 30001 9700 RB Groningen, The Netherlands. Pieter U. Dijkstra, Department of Rehabilitation, University Medical Centre Groningen, University of Groningen, PO Box 30001 9700 RB Groningen, The Netherlands. Ymkje Stienstra, Departments of Internal Medicine and Pulmonary Diseases and Tuberculosis, Infectious Diseases and Tuberculosis Service, University Medical Centre Groningen, University of Groningen, PO Box 30001 9700 RB Groningen, The Netherlands.