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Buruli Ulcer
Buruli ulcer (Mycobacterium ulcerans infection)
Buruli ulcer is caused by a germ that mainly affects the skin but which can also affect the bone. The causative organism is called Mycobacterium ulcerans, which although different, belongs to the same family of organisms that cause leprosy and tuberculosis.
Buruli ulcer has been reported in over 30 countries with tropical and subtropical climates but it may also occur in some countries where it has not yet been recognized. Limited knowledge of the disease, its focal distribution and the fact that it affects mainly poor rural communities contribute to low reporting of cases. Progress is being made now to develop tools for early diagnosis, to understand exactly how infection is transmitted and to improve treatment.
Symptoms
Buruli ulcer often starts as a painless, mobile swelling in the skin called nodule. Infection often leads to extensive destruction of skin and soft tissue with the formation of large ulcers usually on the legs or arms. If patients seek treatment at the early stage, antibiotics can prove to be successful. Delayed treatment may cause irreversible deformity, long-term functional disability such as restriction of joint movement, extensive skin lesions and sometimes life-threatening secondary infections.
Early diagnosis and treatment are vital.
Prevention and Treatment
Research for a vaccine to treat Buruli ulcer is continuing, although the current Bacille Calmette-Guérin (BCG) vaccine appears to offer some short-term protection. A safe and effective vaccine may be the most effective way to combat Buruli ulcer in the long term.
Current WHO recommendations for treatment are as follows:
- A combination of rifampicin and streptomycin/amikacin for eight weeks as a first-line treatment for all forms of the active disease. Nodules or uncomplicated cases can be treated without hospitalization.
- Surgery mainly to remove necrotic tissue, cover skin defects and correct deformities.
- Interventions to minimize or prevent disabilities.
Initiative
The Global Buruli Ulcer Initiative (GBUI) was established in 1998. It is a partnership of Member States, academic and research institutions, donor agencies, nongovernmental organizations and the World Health Organization. The GBUI is dedicated to raising awareness about the disease, improve access to early diagnosis, treatment and promotion of research to develop better tools for the treatment and prevention of Buruli ulcer.
In March 2009 a meeting grouping together heads of state and high level officials of endemic countries in Africa met in Cotonou, Benin where the "Cotonou Declaration" on Buruli ulcer was adopted. French version
For more information, see Buruli ulcer fact sheet
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