Buruli Ulcer Control in a Highly Endemic District in Ghana: Role of Community-Based Surveillance Volunteers

Kabiru Mohammed Abass Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Tjip S. van der Werf Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Richard O. Phillips Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Fred S. Sarfo Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Justice Abotsi Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Samuel Osei Mireku Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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William N. Thompson Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Kingsley Asiedu Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Ymkje Stienstra Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Sandor-Adrian Klis Agogo Presbyterian Hospital, Agogo, Ghana; Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands; Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center, Groningen, The Netherlands; Komfo Anokye Teaching Hospital, Kumasi, Ghana; Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; World Health Organization, Geneva, Switzerland

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Buruli ulcer (BU) is an infectious skin disease that occurs mainly in West and Central Africa. It can lead to severe disability and stigma because of scarring and contractures. Effective treatment with antibiotics is available, but patients often report to the hospital too late to prevent surgery and the disabling consequences of the disease. In a highly endemic district in Ghana, intensified public health efforts, mainly revolving around training and motivating community-based surveillance volunteers (CBSVs), were implemented. As a result, 70% of cases were reported in the earliest—World Health Organization category I—stage of the disease, potentially minimizing the need for surgery. CBSVs referred more cases in total and more cases in the early stages of the disease than any other source. CBSVs are an important resource in the early detection of BU.

Author Notes

* Address correspondence to Sandor-Adrian Klis, Hanzeplein 1, PO Box 30001, 9700RB, Groningen, The Netherlands. E-mail: s.klis@umcg.nl

Authors' addresses: Kabiru Mohammed Abass, Justice Abotsi, Samuel Osei Mireku, and William N. Thompson, Buruli Ulcer Clinic, Agogo Presbyterian Hospital, Agogo, Ghana, E-mails: abas@agogopresbyhospital.org, info@agogopresbyhospital.org, inf@agogopresbyhospital.org, and wnat111@yahoo.com. Tjip S. van der Werf, Ymkje Stienstra, and Sandor-Adrian Klis, Department of Internal Medicine–Infectious Diseases, University of Groningen, University Medical Center, Groningen, The Netherlands, E-mails: t.s.van.der.werf@umcg.nl, y.stienstra@umcg.nl, and s.klis@umcg.nl. Richard O. Phillips and Fred S. Sarfo, Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, and School of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, E-mails: rodamephillips@gmail.com and stephensarfo78@gmail.com. Kingsley Asiedu, Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland, E-mail: asieduk@who.int.

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