%0 Journal Article
%T Buruli Ulcer: Treatment Challenges at Three Centres in Ghana
%A Pius Agbenorku
%A Isaac K. Donwi
%A Pawson Kuadzi
%A Paul Saunderson
%J Journal of Tropical Medicine
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/371915
%X Aims. This retrospective study was to identify some challenges in the treatment of Buruli ulcer (BU) and present a proposed treatment regime. Materials and Methods. Information from patients medical records, hospital database, and follow-up findings on BU treatment procedures from 1994 to 1998 and from 2004 to 2007 at three research sites in Ghana were reviewed to determine the treatment challenges encountered. Data needed were recorded and analyzed, and results presented using SPSS version 17.0. Results. A total of 489 BU patients information was selected for the study. A majority (56.90%, ) of the patients were children (0¨C14 years), with a mean age of 12.8 years. Significant challenges in BU treatment in Ghana identified included sequelae ( ), delayed treatment ( ), and high treatment cost ( ). Duration of hospital stay was clearly correlated with the time spent at home prior to admission; spearman¡¯s rank correlation coefficient was 0.72 (95% CI 0.42¨C0.87). Conclusion. Delays in seeking treatment among BU patients were the main factor which resulted in most of the other factors contributing to the challenges in treatment. A combination of psychosocial and biomedical approach was proposed as holistic method to alleviate the challenges in BU treatment. 1. Introduction Buruli ulcer (BU), the Mycobacterium ulcerans skin ulcer, also known as Bairnsdale ulcer, Daintree ulcer, Mossman ulcer, Kumusi ulcer, Tontokrom ulcer, and Searles¡¯ ulcer, is a chronic, indolent, and necrotizing disease of the skin and soft tissue caused by Mycobacterium ulcerans (MU), which usually begins as a painless nodule or papule and may progress to massive skin ulceration [1¨C3]. If untreated, BU may lead to extensive soft-tissue destruction, with inflammation and subsequent complete tissue necrosis extending to deep fascia and the bone. The parts of the body mostly affected are the extremities, especially the lower ones. Subsequent complications may include contracture deformities, leading to loss or limitations in function and even amputations. BU disease is assuming public health importance in many countries, prompting the establishment of the ¡°Global Buruli Ulcer Initiative¡± by the World Health Organization (WHO) in early 2008 [1]. MU infection was first reported in Bairnsdale, southeast Australia in 1948 [4] and later named Buruli ulcer in Uganda [5]. MU is the third most common mycobacterial infection worldwide, after tuberculosis and leprosy [6, 7]. BU mainly affects individuals in humid, rural, tropical regions with limited access to medical care. BU frequently occurs near
%U http://www.hindawi.com/journals/jtm/2012/371915/