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Challenges associated with management of Buruli ulcer/human immunodeficiency virus coinfection in a treatment center in Ghana : a case series study

Tuffour, Joseph and Owusu-Mireku, Evelyn and Ruf, Marie-Therese and Aboagye, Samuel and Kpeli, Grace and Akuoku, Victor and Pereko, Janet and Paintsil, Albert and Bonney, Kofi and Ampofo, William and Pluschke, Gerd and Yeboah-Manu, Dorothy. (2015) Challenges associated with management of Buruli ulcer/human immunodeficiency virus coinfection in a treatment center in Ghana : a case series study. American journal of tropical medicine and hygiene, 93 (2). pp. 216-223.

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Official URL: http://edoc.unibas.ch/39888/

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Abstract

The synergy between Mycobacterium tuberculosis infection and human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome is well established but not so in Buruli ulcer (BU). We screened confirmed BU cases for HIV infection and followed seven BU/HIV-coinfected patients. Management of BU/HIV was based on the World Health Organization guidelines and patient condition. The HIV positivity among BU patients (8.2%; 11/134) was higher compared with that of general patients attending the facility (4.8%; 718/14,863; P = 0.07) and that of pregnant women alone (2.5%; 279/11,125; P = 0.001). All seven BU/HIV-coinfected cases enrolled in the study presented with very large (category III) lesions with four having multiple lesions compared with 54.5% of category III lesions among HIV-negative BU patients. During the recommended BU treatment with streptomycin and rifampicin (SR) all patients developed immune infiltrates including CD4 T cells in their lesions. However, one patient who received antiretroviral therapy (ART) 1 week after beginning SR treatment developed four additional lesions during antibiotic treatment, while two out of the four who did not receive ART died. Further evidence is required to ascertain the most appropriate time to commence ART in relation to SR treatment to minimize paradoxical reactions.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Molecular Immunology (Pluschke)
UniBasel Contributors:Ruf, Marie-Thérèse and Pluschke, Gerd
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Williams and Wilkins
ISSN:0002-9637
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:30 Jun 2016 11:00
Deposited On:28 Jan 2016 10:15

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