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Multicenter Study of Buruli Ulcer Disabilities in the Head and Neck Region

DOI: 10.1155/2011/647418

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Abstract:

Objective. To identify disabilities caused by Buruli Ulcer Disease (BUD) when it affects the Head and Neck Region (HNR) of patients in endemic areas and suggest possible ways to overcome the complications involved. Methods. Data for the study was collected from six different hospitals in the central part of Ghana from 2004–2009. Diagnosis of BUD was based on clinical findings and confirmed by positive result of Ziehl-Neelson Test for Acid Fast Bacilli, Polymerase Chain Reaction, or Histopathology. Treatment of BUD involved a combination of surgical interventions and antimycobacterial chemotherapy for 8 weeks. Results. The age of the 38 patients ranged from 0–56 years (mean age of 14.3 years), with males outnumbering females. Most (55.3%, ) of the patients reported to the facilities with developed BUD deformities. Patients who lost their eyeball ( ) recorded the highest in terms of functional disability. A mean total hospital stay of 52 days and follow-up period of 2.3 years were recorded for the study. Conclusion. Visual impairment was the commonest form of disability recorded in the HNR. Management difficulties and BUD disabilities could be avoided by early detection of the disease and training of health professionals at district levels. 1. Introduction Buruli ulcer (BU) is a severe disabling and disfiguring disease caused by Mycobacterium ulcerans (MU). Even though cases are reported in all age groups, it affects primarily children less than 15 years of age [1, 2]. Oluwasanmi et al. [3] and van der Werf et al. [2] did not find any sex difference in their studies, but Barker reported prevalence to be higher among women than men and among boys than girls. One characteristic of the disease is its apparent association with aquatic habitat, especially in many tropical and subtropical countries [3–6]. In early or preulcerative lesions, MU produces a lipid toxin, mycolactone, which is responsible for necrosis of the dermis, panniculus, and fascia, culminating in extensive ulcers [7]. Preulcerative lesions and small ulcers may be surgically excised and closed. However, antimicrobial drug therapy is often effective for treatment of early lesions [8]. Large ulcers generally require excision followed by skin grafting [9] in combination with BU chemotherapy [10]. In Ghana, BU is currently the second mycobacterial infection after tuberculosis [11]. According to the Ghana National Buruli Ulcer Control Programme, January—December 2009 Report, 19 cases of BU in the Head and Neck Region (HNR) had been confirmed in various regions of the country, with Ashanti Region

References

[1]  Uganda Buruli Group, “BCG vaccination against Mycobacterium ulcerans infection (Buruli ulcer),” Lancet, vol. 1, pp. 111–115, 1969.
[2]  T. S. van der Werf, W. T. A. van der Graaf, D. G. Groothuis, and A. J. Knell, “Mycobacterium ulcerans infection in Ashanti region, Ghana,” Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 83, no. 3, pp. 410–413, 1989.
[3]  J. O. Oluwasanmi, T. F. Solanke, and E. O. Olurin, “Mycobacterium ulcerans (Buruli) skin ulceration in Nigeria,” American Journal of Tropical Medicine and Hygiene, vol. 25, no. 1, pp. 122–128, 1976.
[4]  K. Muelder, “Wounds that will not heal,” International Journal of Dermatology, vol. 31, no. 1, pp. 25–26, 1992.
[5]  F. Portaels, P. Johnson, and W. M. Meyers, Eds., Buruli ulcer. Diagnosis of Mycobacterium ulcerans Disease, vol. 4, World Health Organization, 2001, WHO/CDS/CPE/GBUI/2001.
[6]  P. Janssens, S. Pattyn, W. M. Meyers, and F. Portaels, “Buruli ulcer: a historical overview with updating to 2005,” Bulletin des Seances/Academie Royale des Sciences d'Outre-Mer, vol. 51, pp. 265–299, 2005.
[7]  K. Asiedu, R. Sherpbier, and M. Raviglione, Eds., Buruli ulcer—Mycobacterium ulcerans Infection, vol. 1, World Health Organization, 2001, WHO/CDS/CPE/GBUI/2001.
[8]  S. Etuaful, B. Carbonnelle, J. Grosset et al., “Efficacy of the combination rifampin-streptomycin in preventing growth of Mycobacterium ulcerans in early lesions of Buruli ulcer in humans,” Antimicrobial Agents and Chemotherapy, vol. 49, no. 8, pp. 3182–3186, 2005.
[9]  V. Sizaire, F. Nackers, E. Comte, and F. Portaels, “Mycobacterium ulcerans infection: control, diagnosis, and treatment,” Lancet Infectious Diseases, vol. 6, no. 5, pp. 288–296, 2006.
[10]  P. Agbenorku, M. Agbenorku, P. Saunderson, and L. Lehman, “The benefits of a combination of surgery and chemotherapy in the management of Buruli ulcer patients,” Journal of Science and Technology, vol. 26, pp. 6–9, 2006.
[11]  G. Amofah, F. Bonsu, C. Tetteh et al., “Buruli ulcer in Ghana: results of a national case search,” Emerging Infectious Diseases, vol. 8, no. 2, pp. 167–170, 2002.
[12]  National Buruli Ulcer Control Programme-Ghana Region Summary Regional Reported Cases of Buruli Ulcer, 2009, http://www.burulighana.org/files/SummaryNat_Data.pdf.
[13]  P. Agbenorku, “Hypertrophic scars,” in Buruli Ulcer. Diagnosis of Mycobacterium ulcerans Disease. A Manual for Health Care Providers, vol. 15, World Health Organization, Geneva, Switzerland, 2001.
[14]  J. Leonardo, “PSEF International Scholar sees allies in Buruli ulcer battle,” Plastic Surgery News, 2000.
[15]  P. Agbenorku and H. Kporku, “Buruli ulcer: a poverty disease?” Indian Journal of Clinical Practice, vol. 3, pp. 23–25, 2001.
[16]  P. Agbenorku, “Mycobacterium ulcerans skin ulcer (MUSU) of the face,” West African Journal of Medicine, vol. 19, pp. 167–169, 2000.
[17]  P. Agbenorku, “Mycobacterium ulcerans disease in the head and neck region,” Indian Journal of Clinical Practice, vol. 6, no. 5, pp. 8–11, 2005.
[18]  K. Kouame, E. Ecra, M. Cisse et al., “Buruli ulcer involving the head: outcomes and therapeutic aspects in 8 cases observed at the University Hospital Center in Abidjan, Cote d'Ivoire,” Medecine Tropicale, vol. 68, no. 6, pp. 643–644, 2008.
[19]  D. M. Phanzu, A. Ablordey, D. B. Imposo et al., “Short report: edematous Mycobacterium ulcerans infection (Buruli ulcer) on the face: a case report,” American Journal of Tropical Medicine and Hygiene, vol. 77, no. 6, pp. 1099–1102, 2007.
[20]  B. J. Marston, M. O. Diallo, C. R. Horsburgh et al., “Emergence of Buruli ulcer disease in the Daloa region of C?te d'Ivoire,” American Journal of Tropical Medicine and Hygiene, vol. 52, no. 3, pp. 219–224, 1995.
[21]  P. Agbenorku, J. Akpaloo, and G. K. Amofa, “Sequelae of Mycobacterium ulcerans infections (Buruli ulcer),” European Journal of Plastic Surgery, vol. 23, no. 6, pp. 326–328, 2000.

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