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E-book Buruli Ulcer : Mycobacterium Ulcerans Disease

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Penilaian

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The first description of skin lesions resembling those caused by Mycobacterium ulcer-ans, dates back to the late nineteenth century, when the missionary physician Albert Cook [1] recorded a range of chronic, necrotizing skin ulcers in patients in Uganda. In the 1950s and 1960s a larger case series of patients with similar ulcers was detected in today’s Nakasongola district in Uganda [2, 3], formerly known as Buruli County. Since then, cases of the disease, henceforth designated “Buruli ulcer” (BU), were reported from 20 additional African countries, where the major burden commonly falls on children aged five to 15 years. BU in Africa is characterized by a patchy geo-graphical distribution, affecting mainly rural communities with often very high local prevalence rates. Access to the formal health sector in these regions is limited and as a result knowledge on the actual distribution and frequency of infections is scanty [4]. The occurrence of M. ulcerans infections in Africa is closely linked to areas of land drained by rivers and their tributaries. While the probability of person-to-person trans-mission is thought to be very low, the nature of relevant environmental reservoirs is highly controversial and the mode by which the pathogen is transmitted from environmental sources to humans is not clarified [5, 6]. Several routes for the intro-duction of M. ulcerans into the susceptible layers of the skin are discussed.Causes of BU disease are commonly perceived by the local population as some-what mysterious and are often associated with witchcraft or sorcery [7–9]. Also insect bites, contamination of skin lesions, and contact with swamps and water bod-ies often connected with changes in ecology are considered risk factors for contract-ing BU and a concept of dual causality is frequently encountered, particularly among affected populations in West African countries [9]. As a consequence, patients may first consult traditional healers or prayer camps to deal with witchcraft before seek-ing biomedical treatment at hospitals or health centers. Other patients may consider care seeking at the formal health sector only as a last resort [8, 10, 11]. Findings from a biosocial analysis of BU among fishermen in northwestern Uganda revealed that late presentation for biomedical treatment resulted from a perceived lack of its effi-cacy and a perceived efficacy of herbalists’ treatment, which was sought promptly after first signs of lesions appeared [12]. These insights explain why in many BU endemic regions a high proportion of patients present to formal health facilities with large lesions, which require extended periods for healing and often result in perma-nent disabilities. According to the WHO classification system, BU lesions fall into one of three categories. Category I includes single, small lesions (nodules or ulcers) below five cm in diameter, Category II comprises single lesions between five and 15 cm in diameter as well as plaque and edematous forms, and Category III includes single lesions above 15 cm in diameter, multiple lesions, lesions at critical sites such as eyes, genitalia, and joints, as well as osteomyelitis [13]. Category II and III lesions are particularly prevalent in remote areas, where access to healthcare is limited and awareness of the disease is low. Surveillance and reporting of cases supported by community health workers, teachers, and other community volunteers are important elements for the control of BU. As long as preventable risks are not clearly identified and no vaccine is available, the main goal is to diagnose and treat patients in an early disease stage, when most lesions heal fast and without adjunct surgical treatment so that long-term sequelae and other complications can be avoided.A momentum for the establishment of organized National BU Control Programs (NBUCPs) in the most affected countries was created by the Yamoussoukro Declaration and the global BU Initiative, launched by WHO in 1998 [14]. The three main pillars of global and national BU control strategies included (1) the strengthening of health sys-tems by the development of infrastructure and provision of training for health workers, (2) sensitization and involvement of communities by information and education cam-paigns to facilitate early case detection and reporting, and (3) standardized case man-agement in terms of diagnosis, treatment, and prevention of disability.

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

616.34 PLU b

Penerbit

Switzerland : Springer Nature., 2019

Deskripsi Fisik

290 hlm

Bahasa

English

ISBN/ISSN

9783030111144

Klasifikasi

616.34

Tipe Isi

text

Tipe Media

computer

Tipe Pembawa

online resource

Edisi

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Subjek

Diseases of Intestine

Info Detail Spesifik

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Pernyataan Tanggungjawab

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Versi lain/terkait

Lampiran Berkas

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