营养支持与标准布路里溃疡治疗相结合的疗效：科特迪瓦案例研究

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2024-11-13 DOI:10.1016/j.jctube.2024.100496

Yao Didier Koffi , Paul Aboa Koffi , Evans Ehouman , Saint-Pierre Kouadio , Mamadou Kaloga

{"title":"营养支持与标准布路里溃疡治疗相结合的疗效：科特迪瓦案例研究","authors":"Yao Didier Koffi , Paul Aboa Koffi , Evans Ehouman , Saint-Pierre Kouadio , Mamadou Kaloga","doi":"10.1016/j.jctube.2024.100496","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Buruli ulcer (BU) is an infectious skin disease caused by <em>Mycobacterium ulcerans</em>. It primarily affects disadvantaged rural populations and mainly impacts children who are chronically malnourished being especially vulnerable. In Côte d’Ivoire, the estimated prevalence of BU in children is 30 %. Malnutrition may further deteriorate the nutritional status of these individuals. This study aimed to compare the healing time of BU patients treated with the standard protocol (SP) of 8 weeks of rifampicin and clarithromycin combined with wound care versus those treated with the standard protocol plus nutritional support using Skin Renewal Medicine-1 (SPSRM-1) (UNHWA Medical Centre, Seoul, Republic of Korea). Additionally, the study measured the effects of SRM-1 on the patients’ nutritional status.</div></div><div><h3>Method</h3><div>This was a prospective, randomized, single-blind paired interventional study conducted in BU-endemic health districts of Côte d’Ivoire. This 12-month study had two arms: the standard protocol versus the test treatment (SPSRM-1). SRM-1 is a cereal-based nutraceutical composed of 60 % cereal, 25 % vegetable, and 15 % plant concentrate. Patients included in the study had uncomplicated category I and II ulcerations without comorbidities. Nutritional status including haemoglobin, albumin levels, and body mass index (BMI) was evaluated from enrolment to the end of the study, alongside ulcer healing rates.</div></div><div><h3>Results</h3><div>Sixty BU wound patients were enrolled: 30 in the control group and 30 in the test group, with a mean age of 22 years. Of the patients, 28.3 % were malnourished, and 42 % had hypoalbuminemia. At the primary endpoint, 6 patients (20.0 %) in the SPSRM1 and 5 patients (16.7 %) in the SP group achieved complete epithelialization, with a reduction rate of 0.7 % per day in the SPSRM1 group compared to 0.3 % per day in the SP group. Patients who received SRM-1 had a higher BMI than those who did not, with a mean difference of 1.72 kg/m<sup>2</sup> favouring the test group. Haemoglobin and albumin levels also showed improvement at the secondary endpoint compared to the control group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the potential benefit of adding nutritional support to improve BU treatment outcomes, by shortening the healing time of ulcerations. However, further studies with larger sample sizes are necessary to confirm these findings.</div></div>","PeriodicalId":37942,"journal":{"name":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","volume":"37 ","pages":"Article 100496"},"PeriodicalIF":1.9000,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of nutritional support in combination with standard Buruli ulcer treatment: A case study in Côte d’Ivoire\",\"authors\":\"Yao Didier Koffi , Paul Aboa Koffi , Evans Ehouman , Saint-Pierre Kouadio , Mamadou Kaloga\",\"doi\":\"10.1016/j.jctube.2024.100496\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Buruli ulcer (BU) is an infectious skin disease caused by <em>Mycobacterium ulcerans</em>. It primarily affects disadvantaged rural populations and mainly impacts children who are chronically malnourished being especially vulnerable. In Côte d’Ivoire, the estimated prevalence of BU in children is 30 %. Malnutrition may further deteriorate the nutritional status of these individuals. This study aimed to compare the healing time of BU patients treated with the standard protocol (SP) of 8 weeks of rifampicin and clarithromycin combined with wound care versus those treated with the standard protocol plus nutritional support using Skin Renewal Medicine-1 (SPSRM-1) (UNHWA Medical Centre, Seoul, Republic of Korea). Additionally, the study measured the effects of SRM-1 on the patients’ nutritional status.</div></div><div><h3>Method</h3><div>This was a prospective, randomized, single-blind paired interventional study conducted in BU-endemic health districts of Côte d’Ivoire. This 12-month study had two arms: the standard protocol versus the test treatment (SPSRM-1). SRM-1 is a cereal-based nutraceutical composed of 60 % cereal, 25 % vegetable, and 15 % plant concentrate. Patients included in the study had uncomplicated category I and II ulcerations without comorbidities. Nutritional status including haemoglobin, albumin levels, and body mass index (BMI) was evaluated from enrolment to the end of the study, alongside ulcer healing rates.</div></div><div><h3>Results</h3><div>Sixty BU wound patients were enrolled: 30 in the control group and 30 in the test group, with a mean age of 22 years. Of the patients, 28.3 % were malnourished, and 42 % had hypoalbuminemia. At the primary endpoint, 6 patients (20.0 %) in the SPSRM1 and 5 patients (16.7 %) in the SP group achieved complete epithelialization, with a reduction rate of 0.7 % per day in the SPSRM1 group compared to 0.3 % per day in the SP group. Patients who received SRM-1 had a higher BMI than those who did not, with a mean difference of 1.72 kg/m<sup>2</sup> favouring the test group. Haemoglobin and albumin levels also showed improvement at the secondary endpoint compared to the control group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated the potential benefit of adding nutritional support to improve BU treatment outcomes, by shortening the healing time of ulcerations. However, further studies with larger sample sizes are necessary to confirm these findings.</div></div>\",\"PeriodicalId\":37942,\"journal\":{\"name\":\"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases\",\"volume\":\"37 \",\"pages\":\"Article 100496\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-11-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2405579424000834\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Tuberculosis and Other Mycobacterial Diseases","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2405579424000834","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

摘要

背景布鲁里溃疡（BU）是一种由溃疡分枝杆菌引起的传染性皮肤病。这种疾病主要影响农村弱势群体，尤其是长期营养不良的儿童。在科特迪瓦，儿童溃疡性结膜炎的发病率估计为 30%。营养不良可能会进一步恶化这些人的营养状况。这项研究旨在比较采用利福平和克拉霉素治疗8周并结合伤口护理的标准方案（SP）治疗的BU患者，与采用标准方案加使用皮肤再生药物-1（SPSRM-1）（大韩民国首尔，联合国近东巴勒斯坦难民救济和工程处医疗中心）的营养支持治疗的BU患者的愈合时间。此外，该研究还测量了 SRM-1 对患者营养状况的影响。方法这是一项前瞻性、随机、单盲配对干预研究，在科特迪瓦的 BU 流行区进行。这项为期 12 个月的研究分为两组：标准方案与试验疗法（SPSRM-1）。SRM-1 是一种谷物营养保健品，由 60% 的谷物、25% 的蔬菜和 15% 的植物浓缩物组成。参与研究的患者均为无并发症的 I 类和 II 类溃疡，无合并症。从注册到研究结束，对患者的营养状况（包括血红蛋白、白蛋白水平和体重指数）以及溃疡愈合率进行了评估：对照组和试验组各 30 人，平均年龄 22 岁。患者中有 28.3% 营养不良，42% 低蛋白血症。在主要终点，SPSRM1 组有 6 名患者（20.0%）和 SP 组有 5 名患者（16.7%）实现了上皮完全脱落，SPSRM1 组的脱落率为每天 0.7%，而 SP 组为每天 0.3%。接受 SRM-1 治疗的患者的体重指数（BMI）高于未接受 SRM-1 治疗的患者，平均相差 1.72 kg/m2，试验组更胜一筹。与对照组相比，血红蛋白和白蛋白水平在次要终点也有所改善。不过，有必要进行样本量更大的进一步研究，以证实这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Efficacy of nutritional support in combination with standard Buruli ulcer treatment: A case study in Côte d’Ivoire

Background

Buruli ulcer (BU) is an infectious skin disease caused by Mycobacterium ulcerans. It primarily affects disadvantaged rural populations and mainly impacts children who are chronically malnourished being especially vulnerable. In Côte d’Ivoire, the estimated prevalence of BU in children is 30 %. Malnutrition may further deteriorate the nutritional status of these individuals. This study aimed to compare the healing time of BU patients treated with the standard protocol (SP) of 8 weeks of rifampicin and clarithromycin combined with wound care versus those treated with the standard protocol plus nutritional support using Skin Renewal Medicine-1 (SPSRM-1) (UNHWA Medical Centre, Seoul, Republic of Korea). Additionally, the study measured the effects of SRM-1 on the patients’ nutritional status.

Method

This was a prospective, randomized, single-blind paired interventional study conducted in BU-endemic health districts of Côte d’Ivoire. This 12-month study had two arms: the standard protocol versus the test treatment (SPSRM-1). SRM-1 is a cereal-based nutraceutical composed of 60 % cereal, 25 % vegetable, and 15 % plant concentrate. Patients included in the study had uncomplicated category I and II ulcerations without comorbidities. Nutritional status including haemoglobin, albumin levels, and body mass index (BMI) was evaluated from enrolment to the end of the study, alongside ulcer healing rates.

Results

Sixty BU wound patients were enrolled: 30 in the control group and 30 in the test group, with a mean age of 22 years. Of the patients, 28.3 % were malnourished, and 42 % had hypoalbuminemia. At the primary endpoint, 6 patients (20.0 %) in the SPSRM1 and 5 patients (16.7 %) in the SP group achieved complete epithelialization, with a reduction rate of 0.7 % per day in the SPSRM1 group compared to 0.3 % per day in the SP group. Patients who received SRM-1 had a higher BMI than those who did not, with a mean difference of 1.72 kg/m² favouring the test group. Haemoglobin and albumin levels also showed improvement at the secondary endpoint compared to the control group.

Conclusion

This study demonstrated the potential benefit of adding nutritional support to improve BU treatment outcomes, by shortening the healing time of ulcerations. However, further studies with larger sample sizes are necessary to confirm these findings.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.