Situation and trends
Buruli ulcer has been reported in more than 33 countries, mainly in those with tropical and subtropical climates. In 2014, cases were reported from 13 countries, most of which are in Africa, where efforts to control the disease have been focused during the past decade. The data available to WHO are limited for three reasons: (i) within endemic countries where cases are being reported regularly, control activities are limited in geographical scope and the data may not therefore reflect the burden at the national level; (ii) there are large areas where limited or no activities are being carried out and the extent of the disease is therefore relatively unknown; (iii) limited knowledge of the disease, its focal distribution and the fact that it affects mainly poor rural communities all contribute to low reporting of cases. In 2014, 2251 new cases of Buruli ulcer were reported globally and 2151 of them in the African Region.