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Buruli Ulcers

Buruli Ulcers. A neglected tropical disease By Geraldine Ambe Walden University 10/24/09. Disease etiology. Environment Agent host interaction Cultural aspects Behaviors Population. Background.

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Buruli Ulcers

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  1. Buruli Ulcers A neglected tropical disease By Geraldine Ambe Walden University 10/24/09

  2. Disease etiology • Environment • Agent host interaction • Cultural aspects • Behaviors • Population

  3. Background • Buruli ulcers known as bairnsdale ulcer, daintree ulcer, mossman ulcer, searl ulcer, necrotizing disease of soft tissue. • Cause mycobacterium ulcerans. • Rapid emergency of disease in most parts of Africa. • WHO tools for better Bu control and surveillance.

  4. Prevalence • Reported in over 30 countries. • Largest numbers in Zaire, Congo, Cameroon, Nigeria, Benin, Ghana, Togo, Liberia, Ivory coast, Australia, southeast Asia.

  5. BARRIERTODETERMINEEXACT PREVALENCE • Under reporting • Under diagnosing • Lack of access to health care • Multiple clinical presentation of disease • Limited knowledge of healthcare workers • Limited public knowledge about the disease

  6. Epidemiology • Occurs near water bodies, rivers, lakes, swams, ponds( activities farming) • Most afflicted children age 15years and under • 90% of lesions on limbs • 60% lower limbs.

  7. MORTALITY AND MORBIDITY • Disease has low mortality rate • High morbidity and socioeconomic burden • Prolong debility • Severely handicapping

  8. Numerical Data • Countries Population 2002 2003 • Benin 6,097,000 565 724 • Cameroon 15,481,00 132 230 • Cote d’ivoire 17,109,00 0 1235 • Ghana 20,212,00 853 739 • Togo 4,629,00 96 56 • Guinee 8,185,820 328 157

  9. Causes • M Ulcerans slow growing mycobacteria causative agent of BU • An environmental pathogen, isolated from biofilms and small aquatic animals of slow moving, or stagnant bodies of water. • Suggested transmission, mosquitoes bites.

  10. Signs and Symptoms • BU starts as a painless, mobile swelling in the skin. • Large area of induration • Diffuse swelling • No pain and fever • Incubation period few weeks to months.

  11. Retrieved from http://www.who.int/buruli/photos/nonulcerative/en/index.html BU STARTS AS A NODULE

  12. Buruli ulcer can extend to 15% of a person's skin surface and may destroy nerves and blood vessels. Metastatic bone lesions may develop

  13. An edematous Buruli ulcer in a 9-year-old Togolese girl (see Media File 3). Courtesy of Wayne M. Meyers, MD.

  14. Togolese girl in Media File 2 taken 5 years after the Buruli ulcer had been excised and repaired with autologous split-skin graft by G.B. Priuli, MD. Courtesy of Wayne M. Meyers, MD

  15. Treatment • WHO Recommendations • Rifampin / Streptomycin • Antimicrobials • Surgical intervention

  16. Social and Cultural Aspects • Sociocultural belief • Fear • Stigma • Loss of productivity • Cost of treatment

  17. Control and Surveillance • Reduce disability • Early detection • Training health care professionals • Case Management • Laboratory case confirmation • Advance health facilities • Monitor, evaluate control activities.

  18. Goals • Improve case finding. • Improve case management • Improve surveillance • Improve Channels of communication. • Increase Research studies on Buruli ulcers.

  19. Audience • Members of heavy burden communities • Medical health care professionals, (Doctors, nurses, laboratory workers, other health clinicians. • Village leaders • community field workers • University medical student and nursing school students.

  20. Organizations • Centers for disease control and prevention (CDC) • UNICEF • World Health Organization (WHO) • Doctors without Borders. • Buruli ulcer control programme Headquaters in Harare Zimbabwe.

  21. ADVOCATES FOR GLOBAL HEALTH

  22. References • Benbow, M.,E. Williamson, H., et al (2008). A large –scale field study on aquatic invertebrates associated with buruli ulcer disease: Are biting water bugs likely vectors? Emerging infectious diseases. Retrieved October 20th,2009 from website http://www.cdc.gov/EID/content/14/8/1247.htm. • Wagner, T., Benbow, M.E., et al (2008). A landscape based model for predicting Mycobacterium ulcerans infections: Buruli ulcer disease presence in Benin, West Africa. EcoHealth. • Guidelines for controlling buruli ulcers in the African Region(2006) World health organization Retrieved October 20th, 2009 from website www.afro.who.int/buruli/english/AFRO%20BU%20guidelines.pdf-similar.

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