1921
Volume 81, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

This study assesses the frequency of recurrences and treatment outcome after surgery of buruli ulcer disease (BUD) with or without concomitant antimycobacterial treatment. Of 129 laboratory-confirmed BUD patients who underwent surgery in two treatment centers in Ghana, 79 (61%) were retrieved for follow-up 4–29 months after the initial treatment. Among 7 (9%) recurrent cases no significant association was found between recurrences and clinical or treatment specific factors including antimycobacterial treatment. In 21 (27%) patients, a reduced range of motion (ROM) of one or more joints was detected. Lesions other than nodules, joint involvement, and skin grafting were identified as independent risk factors. Functional limitations hampering daily activities were perceived by 22% of the patients. Compared with other studies the recurrence rate was relatively low, functional limitations were, however, frequent. This emphasizes the need for improvement of pre- and post-treatment wound care as well as rehabilitation programs.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.2009.81.75
2009-07-01
2017-09-24
Loading full text...

Full text loading...

/deliver/fulltext/14761645/81/1/0810075.html?itemId=/content/journals/10.4269/ajtmh.2009.81.75&mimeType=html&fmt=ahah

References

  1. World Health Organization, 2001. Buruli ulcer. Management of Mycobacterium ulcerans disease. Available at: http://www.whqlibdoc.who.int/hq/2001/WHO_CDS_CPE_GBUI_2001.3.pdf. Accessed August 26, 2008.
  2. van der Werf TS, van der Graaf WT, Tappero JW, Asiedu K, 1999. Mycobacterium ulcerans infection. Lancet 354 : 1013–1018.
  3. World Health Organization, 2008. Buruli ulcer: progress report, 2004–2008. Wkly Epidemiol Rec 17 : 145–156.
  4. Amofah G, Bonsu F, Tetteh C, Okrah J, Asamoa K, Asiedu K, Addy J, 2002. Buruli ulcer in Ghana: results of a national case search. Emerg Infect Dis 8 : 167–170.
  5. Wansbrough-Jones M, Phillips R, 2006. Buruli ulcer: emerging from obscurity. Lancet 367 : 1849–1858.
  6. Portaels F, Elsen P, Guimaraes-Peres A, Fonteyne PA, Meyers WM, 1999. Insects in the transmission of Mycobacterium ulcerans infection. Lancet 353 : 986.
  7. Portaels F, Meyers WM, Ablordey A, Castro AG, 2008. First cultivation and characterization of Mycobacterium ulcerans from the environment. PLoS Negl Trop Dis 2 : e178.
  8. Pszolla N, Sarkar MR, Strecker W, Kern P, Kinzl L, Meyers WM, Portaels F, 2003. Buruli ulcer: a systemic disease. Clin Infect Dis 37 : e78–e82.
  9. Stienstra Y, Dijkstra PU, Guédénon A, Johnson RC, Ampadu EO, Mensah T, Klutse EY, Etuaful S, Deepak S, van der Graaf WT, van der Werf TS, 2004. Development of a questionnaire assessing Buruli ulcer-induced functional limitation. Am J Trop Med Hyg 70 : 318–322.
  10. Stienstra Y, Dijkstra PU, van Wezel MJ, van Roest MH, Beets M, Zijlstra I, Johnson RC, Ampadu EO, Gbovi J, Zinsou C, Etuaful S, Klutse EY, Van der Graaf WT, Van der Werf TS, 2005. Reliability and validity of the buruli ulcer functional limitation score questionnaire. Am J Trop Med Hyg 72 : 449–452.
  11. Stienstra Y, van Roest MHG, van Wezel MJ, Wiersma IC, Hospers IC, Dijkstra PU, Johnson RC, Ampadu EO, Gbovi J, Zinsou C, Etuaful S, Klutse EY, van der Graaf WT, van der Werf TS, 2005. Factors associated with functional limitations and subsequent employment or schooling in Buruli ulcer patients. Trop Med Int Health 10 : 1251–1257.
  12. World Health Organization, 2004. Provisional guidance on the role of antibiotics in the management of Mycobacterium ulcerans disease. Available at: http://www.who.int/entity/buruli/information/antibiotics/en/. Accessed August 26, 2008.
  13. Etuaful S, Carbonnelle B, Grosset J, Lucas S, Horsfield C, Phillips R, Evans M, Ofori-Adjei D, Klustse E, Owusu-Boateng J, Amedofu GK, Awuah P, Ampadu E, Amofah G, Asiedu K, Wansbrough-Jones M, 2005. Efficacy of the combination rifampin-streptomycin in preventing growth of Mycobacterium ulcerans in early lesions of Buruli ulcer in humans. Antimicrob Agents Chemother 49 : 3182–3186.
  14. World Health Organization, 2001. Buruli ulcer: diagnosis of Mycobacterium ulcerans disease. Available at: http://whqlibdoc.who.int/hq/2001/WHO_CDS_CPE_GBUI_2001.4.pdf. Accessed August 26, 2008.
  15. Bretzel G, Siegmund V, Nitschke J, Herbinger KH, Thompson W, Klutse E, Crofts K, Massavon W, Etuaful S, Thompson R, Asamoah-Opare K, Racz P, Vloten F, van Berberich C, Kruppa T, Ampadu E, Fleischer B, Adjei O, 2007. A step-wise approach to the laboratory diagnosis of Buruli ulcer disease. Trop Med Int Health 12 : 89–96.
  16. Gerhardt JJ, Rondinelli RD, 2001. Goniometric techniques for range-of-motion assessment. Phys Med Rehabil Clin N Am 12 : 507–527.
  17. World Health Organization, 2007. Summary report of the WHO annual meeting on Buruli Ulcer, 2–4 April 2007 and report of the technical advisory Group (TAG) meeting, 5 April, Geneva, 2007. Available at: http://www.who.int/buruli/events/Report_2007_meeting_FINAL.pdf. Accessed August 26, 2008.
  18. World Health Organization, 2008. Meeting of the WHO technical advisory group on Buruli ulcer 3 April 2008, Geneva, summary report. Available at: http://www.who.int/buruli/events/TAG_report_FINAL.pdf. Accessed August 26, 2008.
  19. SAS Institute, 2006. SAS 9.1.3. SAS Institute, Cary, NC.
  20. Bretzel G, Siegmund V, Racz P, van Vloten F, Ngos F, Thompson W, Biason P, Adjei O, Fleischer B, Nitschke J, 2005. Post-surgical assessment of excised tissue from patients with Buruli ulcer disease: progression of infection in macroscopically healthy tissue. Trop Med Int Health 10 : 1199–1206.
  21. Chauty A, Ardant MF, Adeye A, Euverte H, Guédénon A, Johnson C, Aubry J, Nuermberger E, Grosset J, 2007. Promising clinical efficacy of streptomycin-rifampin combination for treatment of buruli ulcer (Mycobacterium ulcerans disease). Antimicrob Agents 51 : 4029–4035.
  22. Debacker M, Aguiar J, Steunou C, Zinsou C, Meyers WM, Portaels F, 2005. Buruli ulcer recurrence, Benin. Emerg Infect Dis 11 : 584–589.
  23. Kanga JM, Kacou DE, Sangaré A, Dabila Y, Asse NH, Djakeaux S, 2003. [Recurrence cases observed after surgical treatment of Buruli ulcer in Cote d’Ivoire]. Bull Soc Pathol Exot 96 : 406–409.
  24. Teelken MA, Stienstra Y, Ellen DE, Quarshie E, Klutse E, van der Graaf WT, van der Werf TS, 2003. Buruli ulcer: differences in treatment outcome between two centres in Ghana. Acta Trop 88 : 51–56.
  25. Amofah G, Asamoah S, Afram-Gyening C, 1998. Effectiveness of excision of preulcerative Buruli lesions in field situations in a rural district in Ghana. Trop Doct 28 : 81–83.
  26. World Health Organization, 2004. Buruli ulcer disease. Wkly Epidemiol Rec 79 : 145–149.
  27. World Health Organization, 2006. Buruli ulcer: a manual on how to prevent disability. Available at: http://www.who.int/buruli/information/publications/pod/en/index.html. Accessed August 26, 2008.
  28. Asiedu K, Etuaful S, 1998. Socioeconomic implications of Buruli ulcer in Ghana: a three-year review. Am J Trop Med Hyg 59 : 1015–1022.
  29. Ellen DE, Stienstra Y, Teelken MA, Dijkstra PU, van der Graaf WT, van der Werf TS, 2003. Assessment of functional limitations caused by Mycobacterium ulcerans infection: towards a Buruli ulcer functional limitation score. Trop Med Int Health 8 : 90–96.
  30. Phanzu DM, Bafende EA, Dunda BK, Imposo DB, Kibadi AK, Nsiangana SZ, Singa JN, Meyers WM, Suykerbuyk P, Portaels F, 2006. Mycobacterium ulcerans disease (Buruli ulcer) in a rural hospital in Bas-Congo, Democratic Republic of Congo, 2002–2004. Am J Trop Med Hyg 75 : 311–314.
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.2009.81.75
Loading
/content/journals/10.4269/ajtmh.2009.81.75
Loading

Data & Media loading...

  • Received : 30 Oct 2008
  • Accepted : 15 Apr 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error