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

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 i...

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Published in:Infection Vol. 53; no. 5; pp. 2073 - 2083
Main Authors: Vas Nunes, Jonathan, Wassill, Lars, Mönnink, Giulia, Falama, Abdul-Mac, Mathéron, Hanna, Conteh, Amara, Sesay, Maxwell, Sesay, Aminata, Bolkan, Håkon, Grobusch, Martin P., Schaumburg, Frieder
Format: pictorial research tables/charts Journal Article
Published: Springer Nature Oct2025
Online Access:View this record in EBSCOhost
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      dt: Oct2025
      vid: 53
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s15010-025-02548-2
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        atl: Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone– a prospective cohort study.
      aug:
        au:
          Vas Nunes, Jonathan
          Wassill, Lars
          Mönnink, Giulia
          Falama, Abdul-Mac
          Mathéron, Hanna
          Conteh, Amara
          Sesay, Maxwell
          Sesay, Aminata
          Bolkan, Håkon
          Grobusch, Martin P.
          Schaumburg, Frieder
        affil: Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone
      sug:
        subj:
          Buruli Ulcer Epidemiology
          Buruli Ulcer Therapy
          Wound Care
          Loop-Mediated Isothermal Amplification Methods
          Resource-Limited Settings
          Early Diagnosis
          Human
          Funding Source
          Male
          Female
          Child, Preschool
          Child
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Prospective Studies
          Sierra Leone
          Academic Medical Centers
          Descriptive Statistics
          Microbial Culture and Sensitivity Tests
          Acetylcysteine
          Coinfection
          World Health Organization
          Amputation
          Polyurethanes
          Logistic Regression
          Biochemistry
          Staining and Labeling
          Clinical Information Systems
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: 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.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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