Mycobacterium ulcerans Infection (Buruli Ulcer) in Southwest Nigeria

Yıl 2020, Cilt: 10 Sayı: 02, 82 - 88, 29.11.2020

Adewale Oke Isaac Komolafe Olaoluwa Akinwale Pam Gyang Emmanuel Henry Timothy Nwafor

https://doi.org/10.5799/jmid.748699

Öz

Objectives: Buruli Ulcer Disease (BUD) caused by Mycobacterium ulcerans is a severe neglected tropical disease of the skin, which has been reported in over 33 countries globally including Nigeria where the disease was first reported in 1967 and later in 1975. Since these reports, there has been no research on BU in the southwest Nigeria. In this study we assessed the presence of BUD in five states of the southwest Nigeria.
Method: This was a community-based, cross-sectional study where BU awareness sessions preceded active search for suspected cases. Questionnaires were administered for participants' demography. Swab and fine needle aspirate specimens from suspected BU lesions were subjected to IS2404-based Nested PCR and Real time (qPCR) techniques to confirm BUD.
Results: A total of 256 samples were collected and analyzed between April, 2016 and December, 2018. 157 (61.3%) samples were positive to IS2404 of M. ulcerans. Children below 15 years of age and adults constituted 42 cases (26.8%) and 115 cases (73.2%), respectively. Index BU cases were confirmed in Ekiti 4 (2.5%), Lagos 11 (7.3%), Ondo 16 (10.6%), Osun 61 (38.9%) and the remaining 64 (40.4%) were found in Ogun State. Ogun and Osun States accounted for 79.3% of all confirmed BU cases in this study.
Conclusions: Conclusion: BU cases, for the first time, were confirmed in five states of SW Nigeria with two of them (Ogun and Osun States) indicating endemic situation, hence the need for those states to be kept under surveillance as potential BU flash points. On a larger scale, a robust BU awareness program nationwide should be embarked upon by the government and other stakeholders. J Microbiol Infect Dis 2020; 10(2):82-88.

Anahtar Kelimeler

Buruli ulcer disease, index cases, endemic areas, Mycobacterium ulcerans, Southwest Nigeria

Kaynakça

• 1. O'Brien DP, Jeanne I, Blasdell K, Avumegah M, Athan E. The changing epidemiology worldwide of Mycobacterium ulcerans. Epidemiol Infect 2018; 147:1-8. 2. Oke AA, Komolafe IO, Akinwale OP, Gyang P, Henry S, Nwafor T. Index Cases of Buruli Ulcer Disease in Three States of South-West, Nigeria – A Preliminary Study. IOSR J Pharm Biol Sci 2018; 13(2): 51-56. 3. Johnson PD, Stinear T, Small PL, et al. Buruli ulcer (M. ulcerans infection): new insights, new hope for disease control. PLoS Med. 2005; 2(4):e108. 4. Maman I, Tchacondo T, Kere AB, et al. Molecular Detection of Mycobacterium Ulcerans in The Environment and Its Relationship with Buruli Ulcer Occurrence in Zio And Yoto Districts Of Maritime Region In Togo. PLoS Negl Trop Dis 2018;12(5): e0006455. 5. Oluniyi PE, Oke AA, Komolafe IO. Presumptive Diagnosis of Buruli Ulcer based on Clinical Presentations. J Micro Infec Dis 2017; 7(1):36-41. 6. Roltgen K, Pluschke G. Mycobacterium ulcerans disease (Buruli ulcer): potential reservoirs and vectors. Curr Clin Microbiol Rep 2015; 2:35–43 7. Aboagye SY, Danso E, Ampah KA, et al. Isolation of Non-tuberculous Mycobacteria from the Environment of Ghanaian Communities Where Buruli Ulcer Is Endemic. Appl Environ Microbiol. 2016; 82(14):4320-4329. 8. Tian RB, Niamké S, Tissot-Dupont H, Drancourt M. Detection of Mycobacterium ulcerans DNA in the Environment, Ivory Coast. PLoS One 2016; 11(3):e0151567. 9. Zingue D, Panda A, Drancourt M, et al. A Protocol for Culturing Environmental Strains of the Buruli Ulcer Agent, Mycobacterium ulcerans. Sci Rep 2018; 8(1): 6778-018-25278-Y. 10. Roltgen K, Qi W, Ruf MT, et al. Single Nucleotide Polymorphism Typing Of Mycobacterium Ulcerans Reveals Focal Transmission Of Buruli Ulcer In A Highly Endemic Region Of Ghana. PLoS Negl Trop Dis 2010; 4(7): e751. 11. Debackers M, Aguiar J, Steunou C, et al. Mycobacterium ulcerans disease (Buruli ulcer) in rural hospital, Southern Benin (1997–2001). Emerg Infect Dis 2004; 10:1391-1398. 12. Sarfo FS, Phillips R, Wansbrough-Jones M, Simmonds RE. Recent Advances: Role of Mycolactone in the Pathogenesis and Monitoring of Mycobacterium Ulcerans Infection/Buruli Ulcer Disease. Cell Microbiol 2016; 18(1): 17-29. 13. Nitenberg M, Bénarouche A, Maniti O et al. The potent effect of mycolactone on lipid membranes. PLoS Pathog 2018; 14(1):e1006814. 14. Gray HH and Kingma S. Mycobacterial skin ulcers in Nigeria. Trans R Soc Trop Dis Hyg1967; 61:712-714. 15. Oluwasanmi JO, Solankee TF, Oluri EO, Itayemi SO, Alabi GO, Lucas AO. Mycobacterium ulcerans (Buruli) skin ulceration in Nigeria. Am J Trop Med Hyg 1976; 25:122-128. 16. Chukwuekezie O, Ampadu E, Sopoh G, et al. Buruli ulcer, Nigeria (Letter). Emerg Infect Dis 2007; 13: 782-783. 17. Marion ECK, Adeye A, Kempf M, ChautyA, Marsollier L. Buruli ulcer in South Western Nigeria: A Retrospective Cohort Study of Patients Treated in Benin. PLoS Negl Trop Dis 2015; 9: e3443. 18. Ayelo GA, Anagonou E, Wadagni A, et al. Report of A Series of 82 Cases of Buruli Ulcer from Nigeria Treated in Benin, From 2006 to 2016. PLoS Negl Trop Dis 2018; 12(3): e0006358. 19. Oluniyi PE, Oke AA, Komolafe IO. Presumptive Diagnosis of Buruli Ulcer Based on Clinical Presentations. J Microbiol Infect Dis 2017; 7(1): 36-41. 20. Ukwaja KN, Meka AO, Chukwuka A et al. Buruli Ulcer in Nigeria: Results of a Pilot Case Study in Three Rural Districts. Infect Dis Pov 2016; 5: 39-016-0119-8. 21. Asiedu K, Raviglione M, Scherpbier R et al. Buruli Ulcer. (Mycobacterium ulcerans infection) (WHO/CoS/CPE/GBU1/2000.1) Geneva: WHO (2000) 22. Yeboah-Manu D, Asante-Poku A, Asan-Ampah K, Ampadu ED, Pluschke G. Combining PCR with microscopy to reduce costs of laboratory diagnosis of Buruli ulcer. The Am J Trop Med Hyg 2011; 85(5): 900-904. 23. Stienstra Y, van der Werf TS, Guarner J, et al. Analysis of an IS2404-based PCR for diagnosis of Buruli Ulcer Disease in regions of Ghana where the disease is endemic. J Clin Microbiol 2003; 41:794-797. 24. https://www.nzytech.com/files/brochures/MD02091_PB_V1901.pdf 25. Lavender CJ, Fyfe JAM. Direct Detection of Mycobacterium ulcerans in Clinical Specimens and Environmental Samples. In: Wilks M. (eds) PCR Detection of Microbial Pathogens. Methods in Molecular Biology (Methods and Protocols), 2013, vol 943. Humana Press, Totowa, NJ, USA. 26. Ajogbasile F,Oke AA,Komolafe IO.Knowledge of Buruli Ulcer Disease among Healthcare Professionals in South-West Nigeria.Integrated J Medicine and Med Sci 2020;1(1);11-18. 27. Yotsu RR, Kouadio K, Vagamon B. Skin Disease Prevalence Study in School children in Rural Cote D'ivoire: Implications for Integration of Neglected Skin Diseases (Skin NTDs). PLoS Negl Trop Dis 2018; 12(5): e0006489. 28. Kenu E, Nyarko KM, Seefeld L, et al. Risk factors for Buruli ulcer in Ghana-a case control study in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the eastern region. PLoS Negl Trop Dis 2014; 8(11), e3279. 29. Capela C, Sopoh GE, Houezo JG, et al. Clinical Epidemiology of Buruli Ulcer from Benin (2005-2013): Effect of Time-Delay to Diagnosis on Clinical Forms and Severe Phenotypes. PLoS Negl Trop Dis 2015; 9(9): e0004005 30. WHO. Treatment of Mycobacterium ulcerans Disease (Buruli ulcer): Guidance for health workers. Geneva 2012; 1-66. 31. Seefeld L. Health-Seeking Behaviour of Buruli ulcer affected People in a Rural Sub District of the Eastern Region, Ghana. 2014. https://pub.unibielefeld.de/download/2730302/2730309/Diss_Seefeld_final. Accessed on May 5, 2019.