Prevalence, impact and solutions to Buruli ulcer disease in Nigeria: a review
Main Article Content
Abstract
Background: Buruli ulcer (BU) is an infectious disease caused by Mycobacterium ulcerans. This review brought to the fore the prevalence, burden and solutions to BU disease in Nigeria.
Methodology: A systematic search of literature was conducted using the following search engines, Google, PubMed, Google Scholar, Infolep, WHO website, Web of Science, African Journal Online, Biomed central and BASE Search. A total of 74 articles were found and 30 were included in the review. The searches were done between September and November 2022.
Results: In communities in Nigeria where BU is endemic, myths and cultural values and traditions constitute barriers to the management and control of the disease. BU patients have very long delays before diagnosis and long hospitalization during treatment. This delay in diagnosis is responsible for the high healthcare costs with accompanying deformities and disabilities. Even though the mortality rate from BU is low, the burden has both economic and social dimensions. The patients are stigmatized mainly due to the poor community knowledge of the disease, hence experience social isolation and suffer job losses and high school drop-out rates.
Conclusion: The burden of BU in Nigeria is high. The patients present late which worsens the socio-economic impact of the disease. Increasing awareness of BU among the populace is very essential. Involvement and orientation of traditional healers could facilitate early referral of cases. There is need to decentralize BU treatment services. The mental health needs of BU patients during and after treatment should be given utmost priority.
Downloads
Article Details
Section
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.
How to Cite
References
World Health Organization. Buruli ulcer (Mycobacterium ulcerans infection). WHO. Available at https://www.who.int>Newsroom>Factsheets>Details Accessed 10th February, 2025.
Onwuka CD, Oparaocha ET, Nwoke EA, Onwuka OC. Community awareness and perceptions about Buruli Ulcers. Journal of Medical Care Research and Review. 2021;4(3):1-16.
Meka AO, Chukwu JN, Nwafor CC, Oshi DC, Maduchie NO, Ekeke N. et al. Diagnosis delay and duration of hospitalization of patients with Buruli ulcer in Nigeria. Trans R Soc Trop Med Hyg. 2016; 110:502-309.
Accelerating Integrated Management Initiative. Nigeria CM-NTD Report. 2019. Improving NTD mapping in Nigeria by integrating case management and disease data. March, 2019.
Nwachukwu NO, Ejiofor IU, Onwuchekwa EC. Burden of Mycobacterium ulcerans disease (Buruli ulcer) in Ogbaru district, Anambra State, Nigeria. International Journal of Medical Science and Clinical Invention. 2018;5(10):4104-4107.
Ayelo GA, Anagonou E, Wadagni AC, Baroqui YT, Dossou AD, Houezo JG, et al. Report of a series of 82 cases of Buruli ulcer from Nigeria treated in Benin, from 2006-2016. PLoS Negl Trop Dis. 2018;12(3):e0006358.
Chukwu JN, Meka AO, Nwafor CC, Oshi DC, Madichie NO, Ekeke N. Financial burden of health care for Buruli ulcer patients in Nigeria: the patients’ perspective. Int Health. 2017; 9:36-43.
Owusu AY, Adamba C. The socioeconomic burden of Buruli ulcer disease in the GA West District of Ghana. Ghana Journal of Development Studies. 2012;9(1):5-20.
Collinson S, Frimpong VNE, Agbavor B, Montgomery B, Oppong M,Frimpong M, et al. Barriers to Buruli ulcer treatment completion in the Ashanti and Central regions, Ghana. PLoS Neglected Tropical Diseases. 2020;14(5):e0008369.
Nwafor CC, Meka A, Chukwu JN, Ekeke N, Alphonsus C, Mbah O, et al. Assessment of community knowledge, attitude and stigma of Buruli ulcer disease in Southern Nigeria. African Health Sciences. 2019;(2):2100-2111.
Ike IF, Usman AK, Yelwa SA. Geospatial analysis of Buruli ulcer prevalence in Anambra North, Anambra State. Nigeria. J Prev Inf Cntrl. 2017; 3:1.
Peeters Grietens K, Um Boock A, Peeters H, Hausmann-Muela S, Tooner E, Muela Riberia J. “It is me who endures but my family that suffers”: social isolation as a consequence of the household cost burden of Buruli ulcer free of charge hospital treatment. PLoS Negl Trop Dis. 2008;2:e321.
Mak WW, Mo PK, Cheung RY, Woo J, Cheung FM, et al. Comparative stigma of HIV/AIDS, SARS and tuberculosis in Hong Kong. Soc Sci Med. 2006;63(7):1912-1922.
Van Brakel WH. Measuring health related stigma-a literature review. Psychol Health Med. 2006;11(3):307-334.
Agbenorku P. Buruli ulcer disability in Ghana: The problems and solutions. Journal of Advances in Medicine and Medical Research. 2014;4(6):1355-1365.
Amoako YA, Ackam N, Omuojine J-P, Oppong MN, Owusu-Ansah AG, Abass MK, et al. Caregiver burden in Buruli ulcer disease: Evidence from Ghana. PLoS Negl Trop Dis. 2021;15(6):e0009454.
Ackumey MM, Kwakye-Maclean C, Ampadu EO, de Savigny D, Weiss MG. Health services for Buruli Ucer control: Lessons from a field study in Ghana. PLoS Neglected Tropical Diseases. 2011;5(6):e1187.
Degnonvi H, Fleurel S, Coudereau C, Gnimavo R, Giffon S, Yeramian E, et al. Effect of well drilling on Buruli ulcer incidence in Benin: a case-control, quantitative study. Lancet Planet Health. 2019;3:e349-56.
Wagner T, Benbow ME, Burns M, Johnson RC, Merritt RW, Qi J, et al. A landscape-based model for predicting Mycobacterium ulcerans infection (Buruli Ulcer disease) presence in Benin, west Africa. Ecohealth. 2008; 5:69-79.
Maman I, Makagni TK, Piten E, Patrick HY, Maman H, Tchacondo T. Buruli ulcer: current status and options for future prevention. CAB Reviews. 2020:15:002.
Roltgen K, Pluschke G. Epidemiology and disease burden of Buruli ulcer: a review. Research and Reports in Tropical Medicine. 2015; 6:59-73.
Agbo IE, Johnson RC, Sopoh GE, Nichter M. The gendered impact of Buruli ulcer on the household production of health and social support networks: Why decentralization favors women. PLoS Negl Trop Dis. 2019;13(4):e0007317.
Eze CC, Ekeke C, Alphonsus C, Lehman L, Chukwu JN, Nwafor CC, et al. Effectiveness of self-care interventions for integrated morbidity management of skin neglected tropical diseases in Anambra state, Nigeria. BMC Public Health. 2021; 21:1748.
Yotsu RR, Richardson M, Ishii N. Drugs for treating Buruli ulcer (Mycobacterium ulcerans disease) (Review) Cochrane Database of Systematic Reviews 2018;8:CD012118.
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; 18:17-19.
Zimmermann P, Finn A, Curtis N. Does BCG vaccination protect against non-tuberculous mycobacterial infection? A systematic review and meta-analysis. J Infect Dis. 2018; 218:679-87.
Guarner J. Buruli ulcer: a review of a neglected skin mycobacterial disease. Journal of Clinical Microbiology. 2018;56(4):10-128.
Yotsu RR, Suzuki K, Simmonds RE, Bedimo R, Ablordey A, Yeboah-Manu D, et al. Buruli ulcer: a review of the current knowledge. Current Tropical Medicine Reports. 2018; 5:247-256.