Improving clinical and epidemiological predictors of Buruli ulcer.
BACKGROUND:Buruli ulcer (BU) is a chronic necrotizing infectious skin disease caused by Mycobacterium ulcerans. The treatment with BU-specific antibiotics is initiated after clinical suspicion based on the WHO clinical and epidemiological criteria. This study aimed to estimate the predictive values...
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ftdoajarticles:oai:doaj.org/article:44f5d6d8d0cd475298edcde3acfd0c04 2023-05-15T15:09:52+02:00 Improving clinical and epidemiological predictors of Buruli ulcer. Gilbert Adjimon Ayelo Ghislain Emmanuel Sopoh Jean-Gabin Houezo René Fiodessihoue Dissou Affolabi Ange Dodji Dossou Yves Thierry Barogui Akpeedje Anita Carolle Wadagni Didier Codjo Agossadou Epco Hasker Françoise Portaels Bouke C de Jong Miriam Eddyani 2018-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006713 https://doaj.org/article/44f5d6d8d0cd475298edcde3acfd0c04 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6095624?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006713 https://doaj.org/article/44f5d6d8d0cd475298edcde3acfd0c04 PLoS Neglected Tropical Diseases, Vol 12, Iss 8, p e0006713 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006713 2022-12-31T05:08:07Z BACKGROUND:Buruli ulcer (BU) is a chronic necrotizing infectious skin disease caused by Mycobacterium ulcerans. The treatment with BU-specific antibiotics is initiated after clinical suspicion based on the WHO clinical and epidemiological criteria. This study aimed to estimate the predictive values of these criteria and how they could be improved. METHODOLOGY/PRINCIPAL FINDINGS:A total of 224 consecutive patients presenting with skin and soft tissue lesions that could be compatible with BU, including those recognized as unlikely BU by experienced clinicians, were recruited in two BU treatment centers in southern Benin between March 2012 and March 2015. For each participant, the WHO and four additional epidemiological and clinical diagnostic criteria were recorded. For microbiological confirmation, direct smear examination and IS2404 PCR were performed. We fitted a logistic regression model with PCR positivity for BU confirmation as outcome variable. On univariate analysis, most of the clinical and epidemiological WHO criteria were associated with a positive PCR result. However, lesions on the lower limbs and WHO category 3 lesions were rather associated with a negative PCR result (respectively OR: 0.4, 95%CI: 0.3-0.8; OR: 0.5, 95%IC: 0.3-0.9). Among the additional characteristics studied, the characteristic smell of BU was strongest associated with a positive PCR result (OR = 16.4; 95%CI = 7.5-35.6). CONCLUSION/SIGNIFICANCE:The WHO diagnostic criteria could be improved upon by differentiating between lesions on the upper and lower limbs and by including lesion size and the characteristic smell recognized by experienced clinicians. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 8 e0006713 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Gilbert Adjimon Ayelo Ghislain Emmanuel Sopoh Jean-Gabin Houezo René Fiodessihoue Dissou Affolabi Ange Dodji Dossou Yves Thierry Barogui Akpeedje Anita Carolle Wadagni Didier Codjo Agossadou Epco Hasker Françoise Portaels Bouke C de Jong Miriam Eddyani Improving clinical and epidemiological predictors of Buruli ulcer. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Buruli ulcer (BU) is a chronic necrotizing infectious skin disease caused by Mycobacterium ulcerans. The treatment with BU-specific antibiotics is initiated after clinical suspicion based on the WHO clinical and epidemiological criteria. This study aimed to estimate the predictive values of these criteria and how they could be improved. METHODOLOGY/PRINCIPAL FINDINGS:A total of 224 consecutive patients presenting with skin and soft tissue lesions that could be compatible with BU, including those recognized as unlikely BU by experienced clinicians, were recruited in two BU treatment centers in southern Benin between March 2012 and March 2015. For each participant, the WHO and four additional epidemiological and clinical diagnostic criteria were recorded. For microbiological confirmation, direct smear examination and IS2404 PCR were performed. We fitted a logistic regression model with PCR positivity for BU confirmation as outcome variable. On univariate analysis, most of the clinical and epidemiological WHO criteria were associated with a positive PCR result. However, lesions on the lower limbs and WHO category 3 lesions were rather associated with a negative PCR result (respectively OR: 0.4, 95%CI: 0.3-0.8; OR: 0.5, 95%IC: 0.3-0.9). Among the additional characteristics studied, the characteristic smell of BU was strongest associated with a positive PCR result (OR = 16.4; 95%CI = 7.5-35.6). CONCLUSION/SIGNIFICANCE:The WHO diagnostic criteria could be improved upon by differentiating between lesions on the upper and lower limbs and by including lesion size and the characteristic smell recognized by experienced clinicians. |
format |
Article in Journal/Newspaper |
author |
Gilbert Adjimon Ayelo Ghislain Emmanuel Sopoh Jean-Gabin Houezo René Fiodessihoue Dissou Affolabi Ange Dodji Dossou Yves Thierry Barogui Akpeedje Anita Carolle Wadagni Didier Codjo Agossadou Epco Hasker Françoise Portaels Bouke C de Jong Miriam Eddyani |
author_facet |
Gilbert Adjimon Ayelo Ghislain Emmanuel Sopoh Jean-Gabin Houezo René Fiodessihoue Dissou Affolabi Ange Dodji Dossou Yves Thierry Barogui Akpeedje Anita Carolle Wadagni Didier Codjo Agossadou Epco Hasker Françoise Portaels Bouke C de Jong Miriam Eddyani |
author_sort |
Gilbert Adjimon Ayelo |
title |
Improving clinical and epidemiological predictors of Buruli ulcer. |
title_short |
Improving clinical and epidemiological predictors of Buruli ulcer. |
title_full |
Improving clinical and epidemiological predictors of Buruli ulcer. |
title_fullStr |
Improving clinical and epidemiological predictors of Buruli ulcer. |
title_full_unstemmed |
Improving clinical and epidemiological predictors of Buruli ulcer. |
title_sort |
improving clinical and epidemiological predictors of buruli ulcer. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006713 https://doaj.org/article/44f5d6d8d0cd475298edcde3acfd0c04 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 12, Iss 8, p e0006713 (2018) |
op_relation |
http://europepmc.org/articles/PMC6095624?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006713 https://doaj.org/article/44f5d6d8d0cd475298edcde3acfd0c04 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006713 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
12 |
container_issue |
8 |
container_start_page |
e0006713 |
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1766340965266620416 |