Buruli ulcer, caused by the Mycobacterium ulcerans, occurs in the (sub) tropics, mainly in sub-Saharan Africa, Western Pacific regions and South America, and is a chronic devastating skin disease. In 2015, 2037 new cases of Buruli ulcer were reported globally and 1913 of them in the African Region. In Africa, about 48% of those affected are children under 15 years. Infection often results in destruction of skin tissue with large ulcers on arms and legs. Diagnosis therefore, is partly based on the detection of early nodular (painless) swellings or visible ulcers with optional laboratory confirmation tests. Treatment requires four different approaches: daily injections of antibiotics for 8 weeks, wound care, prevention of disability (exercises, anti-deformity positioning, and elevation and mobilization of the infected limb), and surgery and skin grafts in severe cases. Wound care primarily consists of clean dressings of the ulcers to improve healing. When left untreated, the ulcers can lead to permanent scarring, bone infection, deformity and permanent disability. The scarring and disability often lead to stigmatization, movement limitations, participation restrictions, and social exclusion.
Towards intensified control - The Global Buruli Ulcer Initiative
The Global Buruli Ulcer Initiative has set the priority to minimize suffering, disabilities and socioeconomic burden, whereby early detection and access to antibiotic treatment is crucial. Furthermore, it aims to raise awareness of the disease and to promote the development of better tools for treatment and prevention. In order to achieve intensified control of Buruli Ulcer, a clinical trial of oral antibiotic therapy was started in 2013 in Benin and Ghana. The use of an oral antibiotic regimen would ensure that more people have access to treatment and that it will cure 70% of the total cases in endemic countries by 2020.