Buruli Ulcer: A Tropical Disease That Need Special Intervention

Buruli Ulcer (BU) belong to the list of tropical diseases which are caused by Mycobacterium ulceran, which is characterised by necrosis of subcutaneous tissue leading to chronic, painless and progressive ulcers. Buruli Ulcer mainly affects the skin but can also affect the bone.

image of flesh-eating buruli ulcer 

According to WHO, This bacterium has been reported in 33 countries in Africa, the Americans, Asia, and the Western Pacific. The majority of cases are reported in Western and Central Africa. In 2015, 13 countries reported 2046 cases, in 2016, 1920 cases were reported and in 2017, 2209 cases were also reported. Also, Australia and Nigeria have reported an increasing number of cases.

How to know it's a Buruli Ulcer

One of the symptoms of Buruli Ulcer is that it is a non-healing sore which occurs on the leg or arm which enlarges as times goes by. At the early stage, Buruli Ulcer infections may start as a red lump. An ulcer is usually single, but they can be multiple or recurrent. Some patient with this infection can get a lot of swelling of the infected area and sometimes this may affect a whole limb.

The organisms that cause Buruli Ulcer which is Mycobacterium is a distant relative of organisms which causes tuberculosis and leprosy. Also, this organisms can evade the human body's immune system by producing a toxin called Mycolactone, which destroys immune cells.

 Treatment of Buruli Ulcer

According to WHO, treatment consists of a combination of antibiotics and complement treatment which include:

•   A combination of Rifampicin (10mg/kg once daily) and Streptomycin (15mg/kg once daily)

•   A combination for Rifampicin (10mg/kg once daily) and Clarithromycin (7.5mg/kg twice daily)

For pregnant women, the combination of Rifampicin and Clarithromycin is considered the safer option because of contraindication to streptomycin.

What can be done to Prevent It

Frequent cleaning and washing of the skin or wounds exposed to soil. Never ignore a long-standing painless ulcer and visit medical practitioner regularly.