Buruli ulcer: management in hospital or at public health centers in “brousse”

Abstract

Introduction: Buruli Ulcer (BU) is caused by
Micobacterium Ulcerans, being a rapidly growing pathology in many countries of the tropical and subtropical area
of Africa. Even if vectors and transmitters are yet
unknown, it is supposed that transmission is associated
with water human activities or linked with soil utilization.
These hypotheses are sustained by the results performed
locally, especially in villages.
Aim of this study is to estimate the incidence of BU in
an isolated area of Benin (Zinvié) and to evaluate pathology characteristics, therapy used and their outcomes.
Results: In the 2005-2009 period BU results being
more frequent in the paediatric population, mainly in its
ulcerous appearance on limbs and arms, while the number
of observed cases reduces through time. On the other 
hand, chronic BU (duration > 3 months) increased in  the “brousse” area, consisting mainly of small bushes.
Treatments administered in hospital (surgery) or at public
health facilities (ozonetherapy and natural dressing)
healed the vast majority of patients within 2 months,
without clinically relevant sequelae.
Conclusions: Our observation seems to confirm that
BU incidence is reducing in one of the most isolated zones
of Benin, mainly due to a correct therapy administered in
well-equipped facilities, where high rates of recovery have
been observed. On the other hand, the vast number of
chronic UBs observed in the most isolated zones of the
“brousse” recovered after localized ozonetherapy and natural dressing.