RESUMO
Buruli ulcer is a neglected tropical disease caused by Myocobacterium ulcerans; it manifests as a skin lesion, nodule, or ulcer that can be extensive and disabling. To assess the global burden and the progress on disease control, we analyzed epidemiologic data reported by countries to the World Health Organization during 2010-2017. During this period, 23,206 cases of Buruli ulcer were reported. Globally, cases declined to 2,217 in 2017, but local epidemics seem to arise, such as in Australia and Liberia. In 2013, the World Health Organization formulated 4 programmatic targets for Buruli ulcer that addressed PCR confirmation, occurrence of category III (extensive) lesions and ulcerative lesions, and movement limitation caused by the disease. In 2014, only the movement limitation goal was met, and in 2019, none are met, on a global average. Our findings support discussion on future Buruli ulcer policy and post-2020 programmatic targets.
Assuntos
Úlcera de Buruli/epidemiologia , Úlcera de Buruli/microbiologia , Mycobacterium ulcerans , Fatores Etários , Úlcera de Buruli/diagnóstico , Úlcera de Buruli/história , Doenças Endêmicas , Saúde Global , História do Século XXI , Humanos , Mycobacterium ulcerans/classificação , Mycobacterium ulcerans/genética , Reação em Cadeia da Polimerase , Vigilância da População , Estudos Retrospectivos , Fatores Sexuais , Organização Mundial da SaúdeRESUMO
In 1969, David Barker, his wife and four children moved to Uganda to work at Makerere Medical School in the capital Kampala. During the 1960s, Makerere had become a research and teaching centre with an international reputation based on the work of Trowell, Burkitt, Hutt and many others who had pioneered studies explaining the disease patterns in the West Nile area on the basis of the local climate, nutrition and lifestyle. David Barker was funded by the Medical Research Council to carry out research on a poorly understood disease, Buruli ulcer, joining Scottish surgeon Wilson Carswell, who was later to achieve fame as the role model for Dr Garrigan in Giles Foden's novel The Last King of Scotland.
Assuntos
Úlcera de Buruli/história , Mycobacterium ulcerans/isolamento & purificação , Doenças Negligenciadas/história , Úlcera de Buruli/epidemiologia , Úlcera de Buruli/microbiologia , História do Século XX , Humanos , Estilo de Vida , Doenças Negligenciadas/epidemiologia , Doenças Negligenciadas/microbiologia , Estado Nutricional , Prevalência , Uganda/epidemiologia , Reino Unido/epidemiologiaRESUMO
Mycobacterium ulcerans infections (Buruli ulcer disease) have a long history that can be traced back 150 years. The successive discoveries of the mycobacteria in 1948 and of mycolactone A/B in 1999, the toxin responsible for this dramatic necrotic skin disease, resulted in a paradigm shift concerning the disease itself and in a broader sense, delineated an entirely new role for bioactive polyketides as virulence factors. The fascinating history, biology and chemistry of M. ulcerans infections are discussed in this review.