Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone- a prospective cohort study.

IF 5.4 2区医学 Q1 INFECTIOUS DISEASES

Infection Pub Date : 2025-05-21 DOI:10.1007/s15010-025-02548-2

Jonathan Vas Nunes, Lars Wassill, Giulia Mönnink, Abdul-Mac Falama, Hanna Mathéron, Amara Conteh, Maxwell Sesay, Aminata Sesay, Håkon Bolkan, Martin P Grobusch, Frieder Schaumburg

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引用次数: 0

Abstract

Purpose: There is a high burden of chronic ulcers in Sierra Leone. However, (early) diagnosis and treatment are challenging. Data on endemicity of Mycobacterium ulcerans is limited to WHO reports from 2008 to 2011.

Methods: Patients presenting with wounds at Masanga Teaching Hospital were included in a prospective cohort study and scored following the WHO clinical list for Buruli ulcer (BU). Wounds were screened for M. ulcerans by selective culture on solid and liquid media and loop-mediated isothermal amplification (LAMP) of the M. ulcerans specific IS2404.

Results: Between July 2019 and November 2020, 159 patients were included. The median age was 41 years (range: 2-92), 34% (54/159) were female and 56% (89/159) were literate. The median duration of a wound before admission was 12 months (range: 0-720 months), 87% (137/159) of lesions were below the knee. Wounds of 37% (58/159) of the patients were clinically scored as '(very) likely to be Buruli ulcer'. Seven out of 72 patients tested by LAMP were positive for IS2404, two showed specific melting curves. None of the wound swabs yielded a positive culture for M. ulcerans. Ninety-eight (62%) patients had a wound-related surgery during this study, 101 (63%) of patients were improving or healed at the time of discharge.

Conclusions: The prevalence of BU based on the WHO scoring system is high in Sierra Leone. National and international awareness, training of healthcare workers, development of in-country bacteriology as well as the furthering of robust molecular and immunological assays could reduce the burden of this neglected tropical disease.

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塞拉利昂通科利利区布鲁里溃疡疑似病例——一项前瞻性队列研究。

目的：塞拉利昂的慢性溃疡负担很高。然而，（早期）诊断和治疗具有挑战性。关于溃疡分枝杆菌地方性的数据仅限于世卫组织2008年至2011年的报告。方法：在马桑加教学医院就诊的伤口患者被纳入前瞻性队列研究，并按照世卫组织布鲁里溃疡（BU）临床清单进行评分。通过在固体和液体培养基上的选择性培养和溃疡分枝杆菌特异性IS2404的环介导等温扩增（LAMP）来筛选伤口中的溃疡分枝杆菌。结果：2019年7月至2020年11月，纳入159例患者。中位年龄为41岁（范围：2-92岁），34%（54/159）为女性，56%（89/159）为文盲。入院前伤口的中位持续时间为12个月（范围：0-720个月），87%（137/159）的病变位于膝盖以下。37%（58/159）患者的伤口临床评分为“（非常）可能为布鲁里溃疡”。经LAMP检测的72例患者中，7例IS2404阳性，2例出现特异性融化曲线。所有伤口拭子均未产生溃疡分枝杆菌阳性培养。在本研究中，98例（62%）患者进行了与伤口相关的手术，101例（63%）患者在出院时病情改善或愈合。结论：基于世卫组织评分系统的布鲁里溃疡患病率在塞拉利昂很高。提高国家和国际认识、培训保健工作者、发展国内细菌学以及进一步开展强有力的分子和免疫学分析，可减轻这一被忽视的热带病的负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Infection 医学-传染病学

CiteScore

12.50

自引率

1.30%

发文量

224

审稿时长

6-12 weeks

期刊介绍： Infection is a journal dedicated to serving as a global forum for the presentation and discussion of clinically relevant information on infectious diseases. Its primary goal is to engage readers and contributors from various regions around the world in the exchange of knowledge about the etiology, pathogenesis, diagnosis, and treatment of infectious diseases, both in outpatient and inpatient settings. The journal covers a wide range of topics, including: Etiology: The study of the causes of infectious diseases. Pathogenesis: The process by which an infectious agent causes disease. Diagnosis: The methods and techniques used to identify infectious diseases. Treatment: The medical interventions and strategies employed to treat infectious diseases. Public Health: Issues of local, regional, or international significance related to infectious diseases, including prevention, control, and management strategies. Hospital Epidemiology: The study of the spread of infectious diseases within healthcare settings and the measures to prevent nosocomial infections. In addition to these, Infection also includes a specialized "Images" section, which focuses on high-quality visual content, such as images, photographs, and microscopic slides, accompanied by brief abstracts. This section is designed to highlight the clinical and diagnostic value of visual aids in the field of infectious diseases, as many conditions present with characteristic clinical signs that can be diagnosed through inspection, and imaging and microscopy are crucial for accurate diagnosis. The journal's comprehensive approach ensures that it remains a valuable resource for healthcare professionals and researchers in the field of infectious diseases.