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Laboratory diagnosis of Buruli ulcer : challenges and future perspectives

Röltgen, K. and Cruz, I. and Ndung'u, J. M. and Pluschke, G.. (2019) Laboratory diagnosis of Buruli ulcer : challenges and future perspectives. In: Buruli ulcer: mycobacterium ulcerans disease. Cham, pp. 183-202.

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Abstract

Current options to control Buruli ulcer (BU) are limited, as no effective vaccine is available and knowledge on transmission mechanisms of the causative agent, Mycobacterium ulcerans, is incomplete. Early case detection and rapid initiation of treatment are key elements to prevent the development of large, disfiguring ulcers often associated with permanent physical disability and stigma. BU has been reported from 34 countries, with the greatest disease burden in West Africa and steadily increasing case numbers in south-eastern Australia. The disease can present in a variety of clinical manifestations, including relatively unspecific, painless nodules, plaques, and edema, which may eventually progress to chronic, ulcerative lesions. The clinical diagnosis of BU is therefore complicated by a broad differential diagnosis, particularly in tropical areas, where the prevalence of other skin conditions with a similar appearance is high. With the introduction of combination antibiotic therapy, replacing excision surgery as the standard treatment for BU, pre-treatment confirmation of the clinical diagnosis has further gained in importance to avoid the redundant use of anti-mycobacterial drugs. At present, available confirmatory diagnostic tests either lack sufficient sensitivity/specificity or are centralized and thus often not accessible to patients living in remote, rural areas of Africa. In recognition of this disparity, WHO and other stakeholders have called for new diagnostic tools for BU that can be applied at district hospitals or primary healthcare facilities. This chapter highlights challenges, advances and future prospects for the necessary decentralization of the diagnosis of BU.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Medical Parasitology and Infection Biology > Molecular Immunology (Pluschke)
UniBasel Contributors:Röltgen, Katharina and Pluschke, Gerd
Item Type:Book Section, refereed
Book Section Subtype:Further Contribution in a Book
Publisher:Springer
ISBN:978-3-030-11114-4
Note:Publication type according to Uni Basel Research Database: Book item
Language:English
Identification Number:
Last Modified:10 Jul 2019 12:52
Deposited On:10 Jul 2019 12:52

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