Presentation On Buruli Ulcer

BURULI ULCER DISEASE

WHAT IS BURULI ULCER ? Buruli ulcer, is a devastating skin disease caused

by Mycobacterium ulcerans. It is named after a region called Buruli, near the

Nile river in Uganda, where in 1961 the first large number of cases were reported. But the first case of BU was reported in Australia in 1948.

It is one of the most neglected but treatable tropical diseases.

The causative organism is from the family of bacteria which causes tuberculosis and leprosy but Buruli ulcer has received less attention than these diseases.

Infection leads to extensive destruction of skin and soft tissue with the formation of large ulcers usually on the legs or arms.

Patients who are not treated early often suffer long-term functional disability such as restriction of joint movement.

Early diagnosis and treatment are vital in preventing such disabilities.

EPIDEMIOLOGY Buruli ulcer occurs most frequently among people

who live or work close to rivers and slow- moving bodies of water.

Activities that take place near water bodies, such as farming, are risk factors, and wearing protective clothing appears to reduce the risk of the disease.

The reasons for the growing spread of BU remain unclear.

All ages and sexes are affected, but most patients are among children under 15 years.

The disease can affect any part of the body, about 90% of the cases are on the limbs, with nearly 60% of all lesions on the lower limbs.

Unlike tuberculosis (TB), there is no evidence to suggest that infection with the human immunodeficiency virus (HIV) predisposes individuals to BU infection.

There is also no evidence that the disease can be transmitted from person to person.

THE ORGANISM M. ulcerans is an environmental

mycobacterium. The organism does not live freely in the

environment The organism occupies a specific place

within aquatic environments (e.g. small aquatic animals, biofilms) from where it is transmitted to humans by an unknown mechanism.

M. ulcerans produces a destructive toxin, mycolactone, which causes tissue damage and inhibits the immune response.

TRANSMISSION The exact mode of transmission is still under

investigation. More recent data from Australia suggest

that salt marsh mosquitoes test positive for M. ulcerans DNA,

Transmission by this type of mosquito has not been established.

Further research is in progress to establish the exact role of insects and other factors in the transmission of the disease to humans.

If confirmed, BU will be the only known mycobacterial disease to be transmitted by insects

DISTRIBUTION OF THE DISEASE

About 33 countries worldwide report the disease. Eg. Benin,Cameron,Togo, Australia, Côte d'Ivoire, Papua New Guinea etc

In Ghana, Ashanti, Brong Ahafo, Central, Eastern, Greater Accra and Western regions routinely report on the disease.

Some endemic districts in Ghana are

Amansie West, Amansie Central, Ahafo Ano NorthAsante Akim NorthAtwima NwabiagyaSekyere Afram Plains

Upper DenkyiraGa WestAkwapim SouthAsutifi North & SouthSuhum Kraboa CoaltarDormaa East / West

GomoaBiaAhanta WestAsunafo North&SouthAhanta West

COUNTRIES WHERE BURULI IS REPORTED

•Buruli ulcer is still considered a “mystery” disease that many people do not know about.(Health Workers, Teachers, Pastors, Herbalists, Jounalists, Lawmakers, Law enforcers , General Society)•As a result, it is under-reported (or poorly documented). •Today, Buruli ulcer is reported in 33 countries worldwide. •Within countries, Buruli ulcer occurs in some localized places .

CONTROL STRATEGIES

In the absence of effective tools to control BU,current control strategies are aimed at reducing the prolonged suffering disabilities and socioeconomic burden associated with the disease

.Community level activities Early case detectionat the community level

using CBSVs Information,education and co,,unication (IEC)

campaigns in communities and schools Training of CBSVs and strenghtening of

comminity based surveillance system

Strenghtening of health system Infracstucture,equipment and logistics

(decentralized health centers) training of health workers. Standardised recording and reporting

using BUO1, BUO2 and BUO4. Standardised case management Specific antibiotics Wound care Surgery POD laboratory confirmation of cases

CLINICAL FORMS.

NODULE PLAQUE OEDEMA ULCER OSTEOMYELITIS

NODULE STAGETHIS IS USUALLY PAINLESS,PALPABLE,FIRM LESION 1-2 CM IN DIAMETER,SITUATED IN THE SUBCUTANEOUS TISSUE AND TYPICALLY ATTACHED TO THE SKIN.

PLAQUE STAGEIS USUALLY PAINLESS,WELL-DEMARCATED,ELEVATED,INDURATED

LESION,MORE THAN 2CM IN DIAMETER.

OEDEMA STAGEDiffuse, extensive, usually non-pitting swelling. The affected area has ill-defined margins, is firm and painless and involves part or all of a limb or other part of the body. There may be colour changes over the affected area and the disease may be accompanied by fever.

OSTEOMYELITIS

ULCERATIVE STAGEA TYPICAL BU IS DEFINED AS A SKIN ULCER CHARACTERIZED BY NECROTIC SLOUGH AND UNDERMINED EDGES. IN THE ABSENCE OF SECONDARY BACTERIAL INFECTION, THE ULCER IS USUALLY

PAINLESS.

Presentation On Buruli Ulcer

Health & Medicine

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