Buruli Ulcer (BU) caused by Mycobacterium ulcerans is a chronic debilitating disease that affects mainly the skin and sometimes bone. The organism belongs to the family of bacteria that causes tuberculosis and leprosy. The organism is an environmental bacterium and the mode of transmission to humans remains unknown. Early diagnosis and treatment are crucial to minimizing morbidity, costs and preventing long-term disability.
The disease is curable but can cause serious disability if diagnosed late or not properly managed.
BU affects all age groups and both sexes, however, children less than 15 years of age are predominantly (more than 70%) affected, especially the impoverished inhabitants of remote rural areas. It affects any part of the body but is seen mostly in the lower limbs.
Signs & Symptoms
Possible risk factors for BU:
- Residence near water bodies e. g slow-flowing rivers, streams or marshy areas etc
- Contact with marshy environment e.g. through occupational activities or visit
- Environmental changes and degradation through various forms of land use e.g artificial ponds and lakes.
- Pricks or abrasions of the skin
Buruli Ulcer should be suspected if a person presents with;
- Painless swelling (papule, nodule, plaque, oedema)
- Or a painless ulcer with undermined edge
- or a typical scar
Especially in those residing near rivers or swamps and are less than 15 years of age
The treatment of Buruli ulcer requires that all patients be managed as follows:
- Treat it as early as possible
- Ensure full compliance with antibiotic treatment
- Avoid cross-infections
- Promote rapid healing
- Prevent complications and treat them in case they happen
- Prevent recurrence
The methods of treatment for Buruli ulcer include
- Chemotherapy using a combination of Rifampicin (10mg/kg body weight) and Clarithromycin (7.5mg/Body kg) by direct observation for 8 weeks
- Wound care
- Surgery (debridement, excision, skin grafting, contracture release)
- Prevention of impairment & disability (POID)
- Psycho-social support