Project Summary
Buruli ulcer (BU), a debilitating disease which leaves victims with permanent deformities is best controlled by detecting early stages of the disease and initiating antibiotics treatment promptly.
The project aimed at reducing or preventing BU morbidity in the Asante AkimNorth district of Ghana through
- promoting active case finding
- strengthening capacity of the district hospital to diagnose and treat BU
- developing a field test for BU diagnosis.
Forty Community Based Surveillance Volunteers (CBSVs) and Health workers (HWs) were trained to actively search for cases in communities. This was complimented with community sensitization and screening activities. The project has set up a laboratory in the district hospital for the confirmation of BU disease by PCR and has trained two technicians in PCR diagnosis. A simple and rapid test, based on the loop mediated isothermal amplification of DNA was developed for the confirmation of BU diagnosis. The IS2404 LAMP is as sensitive and specific as the reference BU diagnostic test (IS2404 PCR) and has potential for further development into a point of care test.
The majority (70-83%) of the patients were reported with preulcerative lesions and were referred by CBSVs and HWs. Less than 3.5% of the patients presented advanced (category III) ulcers. Confirmation of BU diagnosis by PCR is now completed within two days, which leads to significant reduction in treatment delay.Some W.H.O recommendations for BU control at the district level were realized namely (i) detection of at least 80% of BU cases at the pre/early ulcer stages(ii) confirmation of at least 50% of cases by PCR and (iii)recording of less than 5% of BU complication. However substantial rise in joint movement limitation among patients from neighboring endemic districts gives indication of the urgent need for the extension of early case detection activities.
