Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.
BACKGROUND:Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier. METHODS:Clinically BU suspicious...
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ftdoajarticles:oai:doaj.org/article:c0f11ba028774e538d0283ebae004acb 2023-05-15T15:17:44+02:00 Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana. Naa Okaikor Addison Stefanie Pfau Eric Koka Samuel Yaw Aboagye Grace Kpeli Gerd Pluschke Dorothy Yeboah-Manu Thomas Junghanss 2017-02-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005331 https://doaj.org/article/c0f11ba028774e538d0283ebae004acb EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5345880?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005331 https://doaj.org/article/c0f11ba028774e538d0283ebae004acb PLoS Neglected Tropical Diseases, Vol 11, Iss 2, p e0005331 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005331 2022-12-31T14:52:22Z BACKGROUND:Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier. METHODS:Clinically BU suspicious patients were enrolled between October 2013 and August 2015 at a primary health care (PHC) center and a municipal hospital, secondary health care (SHC) center in Ghana. All patients were IS2404 PCR tested and divided into IS2404 PCR positive and negative groups. The course of wound healing was prospectively investigated including predictors of wound closure and assessment of infrastructure, supply and health staff performance. RESULTS:53 IS2404 PCR positive patients-31 at the PHC center and 22 at the SHC center were enrolled-and additionally, 80 clinically BU suspicious, IS2404 PCR negative patients at the PHC center. The majority of the skin ulcers at the PHC center closed, without the need for surgical intervention (86.7%) compared to 40% at the SHC center, where the majority required split-skin grafting (75%) or excision (12.5%). Only 9% of wounds at the PHC center, but 50% at the SHC center were complicated by bacterial infection. The majority of patients, 54.8% at the PHC center and 68.4% at the SHC center, experienced wound pain, mostly severe and associated with wound dressing. Failure of ulcers to heal was reliably predicted by wound area reduction between week 2 and 4 after initiation of treatment in 75% at the PHC center, and 90% at the SHC center. Obvious reasons for arrested wound healing or deterioration of wound were missed additional severe pathology; at the PHC center (chronic osteomyelitis, chronic lymphedema, squamous cell carcinoma) and at the SHC center (malignant ulceration, chronic lymphedema) in addition to hygiene and wound care deficiencies. When clinically suspicious, but IS2404 PCR negative patients were recaptured in the community, 76/77 (98.7%) of analyzed wounds were either completely ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 2 e0005331 |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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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 Naa Okaikor Addison Stefanie Pfau Eric Koka Samuel Yaw Aboagye Grace Kpeli Gerd Pluschke Dorothy Yeboah-Manu Thomas Junghanss Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier. METHODS:Clinically BU suspicious patients were enrolled between October 2013 and August 2015 at a primary health care (PHC) center and a municipal hospital, secondary health care (SHC) center in Ghana. All patients were IS2404 PCR tested and divided into IS2404 PCR positive and negative groups. The course of wound healing was prospectively investigated including predictors of wound closure and assessment of infrastructure, supply and health staff performance. RESULTS:53 IS2404 PCR positive patients-31 at the PHC center and 22 at the SHC center were enrolled-and additionally, 80 clinically BU suspicious, IS2404 PCR negative patients at the PHC center. The majority of the skin ulcers at the PHC center closed, without the need for surgical intervention (86.7%) compared to 40% at the SHC center, where the majority required split-skin grafting (75%) or excision (12.5%). Only 9% of wounds at the PHC center, but 50% at the SHC center were complicated by bacterial infection. The majority of patients, 54.8% at the PHC center and 68.4% at the SHC center, experienced wound pain, mostly severe and associated with wound dressing. Failure of ulcers to heal was reliably predicted by wound area reduction between week 2 and 4 after initiation of treatment in 75% at the PHC center, and 90% at the SHC center. Obvious reasons for arrested wound healing or deterioration of wound were missed additional severe pathology; at the PHC center (chronic osteomyelitis, chronic lymphedema, squamous cell carcinoma) and at the SHC center (malignant ulceration, chronic lymphedema) in addition to hygiene and wound care deficiencies. When clinically suspicious, but IS2404 PCR negative patients were recaptured in the community, 76/77 (98.7%) of analyzed wounds were either completely ... |
format |
Article in Journal/Newspaper |
author |
Naa Okaikor Addison Stefanie Pfau Eric Koka Samuel Yaw Aboagye Grace Kpeli Gerd Pluschke Dorothy Yeboah-Manu Thomas Junghanss |
author_facet |
Naa Okaikor Addison Stefanie Pfau Eric Koka Samuel Yaw Aboagye Grace Kpeli Gerd Pluschke Dorothy Yeboah-Manu Thomas Junghanss |
author_sort |
Naa Okaikor Addison |
title |
Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana. |
title_short |
Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana. |
title_full |
Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana. |
title_fullStr |
Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana. |
title_full_unstemmed |
Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana. |
title_sort |
assessing and managing wounds of buruli ulcer patients at the primary and secondary health care levels in ghana. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005331 https://doaj.org/article/c0f11ba028774e538d0283ebae004acb |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 2, p e0005331 (2017) |
op_relation |
http://europepmc.org/articles/PMC5345880?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005331 https://doaj.org/article/c0f11ba028774e538d0283ebae004acb |
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https://doi.org/10.1371/journal.pntd.0005331 |
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PLOS Neglected Tropical Diseases |
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11 |
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2 |
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e0005331 |
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