Buruli ulcer

Development of methods for early diagnosis

Rationale

Although Buruli ulcer can be confirmed in tertiary hospitals or research laboratories equipped with modern techniques including histopathology, culture and PCR , today there are no simple tools for early diagnosis that can be implemented in the rural areas of developing countries where the burden of disease exists.

This is especially unfortunate since treatment of Buruli ulcer in its early stages can be carried out locally with little trauma to the patient whereas the treatment of the late stages of the disease requires extensive surgery at major hospitals, prolonged hospitalization, and is very expensive.

Furthermore, early forms of the disease is known to respond to antibiotic therapy, thus avoiding the need for surgery. The most desirable method of diagnosis would be a simple blood test to determine if a person has M. ulcerans infection or a test based on examination of a small amount of tissue from a suspected lesion.

The assay should preferably be carried out by simple colorimetry or agglutination that can be done in a rural hospital. Such assays are available for many infectious diseases. Thus high priority needs to be given to development of a good early diagnostic test and the information from the Mycobacterium ulcerans genome sequencing will contribute to this effort.

Recommended studies:

  • To identify M. ulcerans specific proteins in lesions;
  • To identify M. ulcerans toxin, mycolactone in lesions;
  • To identify M. ulcerans specific antibodies in blood.
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