Risk Factors for Buruli Ulcer in Ghana—A Case Control Study in the Suhum-Kraboa-Coaltar and Akuapem South Districts of the Eastern Region

Autor: Edwin Afari, Oliver Razum, Michael Käser, Ernest Kenu, Kwodwo Koram, Linda Seefeld, Margaret Lartey, Vincent Ganu, Richard Adanu, Fred Binka, Benedict Calys-Tagoe, Kofi Mensah Nyarko
Jazyk: angličtina
Rok vydání: 2014
Předmět:
Buruli ulcer
Male
Ghana
Hygiene
Residence Characteristics
Risk Factors
Surveys and Questionnaires
Medicine and Health Sciences
Medicine
Child
Buruli Ulcer
media_common
Aged
80 and over
biology
Geography
lcsh:Public aspects of medicine
Agriculture
Middle Aged
Infectious Diseases
Mycobacterium ulcerans
Child
Preschool
Conditional logistic regression
Female
Research Article
Adult
INSECT BITES
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine
Adolescent
lcsh:RC955-962
media_common.quotation_subject
Young Adult
Rivers
Environmental health
Animals
Humans
Aged
business.industry
Public Health
Environmental and Occupational Health
Case-control study
Insect Bites and Stings
lcsh:RA1-1270
medicine.disease
biology.organism_classification
Case definition
Surgery
Logistic Models
Case-Control Studies
Wetlands
business
Zdroj: PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Vol 8, Iss 11, p e3279 (2014)
ISSN: 1935-2735
1935-2727
Popis: Background Buruli ulcer (BU) is a skin disease caused by Mycobacterium ulcerans. Its exact mode of transmission is not known. Previous studies have identified demographic, socio-economic, health and hygiene as well as environment related risk factors. We investigated whether the same factors pertain in Suhum-Kraboa-Coaltar (SKC) and Akuapem South (AS) Districts in Ghana which previously were not endemic for BU. Methods We conducted a case control study. A case of BU was defined as any person aged 2 years or more who resided in study area (SKC or AS District) diagnosed according to the WHO clinical case definition for BU and matched with age- (+/−5 years), gender-, and community controls. A structured questionnaire on host, demographic, environmental, and behavioural factors was administered to participants. Results A total of 113 cases and 113 community controls were interviewed. Multivariate conditional logistic regression analysis identified presence of wetland in the neighborhood (OR = 3.9, 95% CI = 1.9–8.2), insect bites in water/mud (OR = 5.7, 95% CI = 2.5–13.1), use of adhesive when injured (OR = 2.7, 95% CI = 1.1–6.8), and washing in the Densu river (OR = 2.3, 95% CI = 1.1–4.96) as risk factors associated with BU. Rubbing an injured area with alcohol (OR = 0.21, 95% CI = 0.008–0.57) and wearing long sleeves for farming (OR = 0.29, 95% CI = 0.14–0.62) showed protection against BU. Conclusion This study identified the presence of wetland, insect bites in water, use of adhesive when injured, and washing in the river as risk factors for BU; and covering limbs during farming as well as use of alcohol after insect bites as protective factors against BU in Ghana. Until paths of transmission are unraveled, control strategies in BU endemic areas should focus on these known risk factors.
Author Summary Mycobacterium ulcerans is the causative agent of Buruli ulcer (BU) which affects the skin, can lead to extensive ulceration, and often results in disabilities. The exact mode of transmission of the disease is still unknown. Previous studies have identified demographic, socio-economic, health and hygiene, as well as environment, related risk factors for BU. This case-control study was done to ascertain the risk factors in a study area in Ghana which was previously non-endemic for BU. The study involved 226 participants, of which 50% were BU confirmed cases and 50% age-, gender-, and community matched controls (persons who had no signs or symptoms of active or inactive BU). This study found presence of wetland, insect bites in water, use of adhesive when injured, and washing in the Densu river as risk factors associated with BU. These factors were similar to previous studies and hence should be used in the implementation of national BU control strategies.
Databáze: OpenAIRE
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