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PLoS Negl Trop Dis 2020 Jun 26;14(6):e0008357. Epub 2020 Jun 26.

Swiss Tropical and Public Health Institute, Basel, Switzerland.

Mycolactones, macrolide cytotoxins, are key virulence factors of Mycobacterium ulcerans, the etiological agent of the chronic necrotizing skin disease Buruli ulcer. There is urgent need for a simple point-of-care laboratory test for Buruli ulcer and mycolactone represents a promising target for the development of an immunological assay. However, for a long time, all efforts to generate mycolactone-specific antibodies have failed. Read More

Antimicrob Agents Chemother 2020 Jun 22. Epub 2020 Jun 22.

Barwon Health, University Hospital Geelong, Geelong, Australia.

Combination antibiotic therapy is highly effective in curing Buruli ulcer (BU), caused by Treatment failures have been uncommonly reported with the recommended 56 days of antibiotics, and little is known about risk factors for treatment failure.We analysed treatment failures among BU patients treated for ≥56 days of antibiotics from a prospective observational cohort at Barwon Health, Victoria, from 1/1/1998-31/12/2018. Treatment failure was defined as culture positive recurrence within 12 months of commencing antibiotics that occurred: a) following failure to heal the initial lesion, or b) a new lesion developing at the original or new site. Read More

PLoS Negl Trop Dis 2020 Jun 22;14(6):e0008051. Epub 2020 Jun 22.

Department of Dermatology, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga, Japan.

Background: In Japan, Buruli ulcer cases are often advanced, requiring surgical treatment. However, extensive debridement is often difficult because of cosmetic and functional sequelae. Moreover, the lesions are complicated and composed of edematous erythema, necrotic ulcer, and erythematous skin lesions caused by a paradoxical reaction, which also make it difficult to perform adequate debridement. Read More

Pan Afr Med J 2020 24;35:54. Epub 2020 Feb 24.

Nigeria Field Epidemiology and Laboratory Training Programme, Abuja, Nigeria.

Introduction: Nigeria is among the countries with high Tuberculosis (TB) burden by global rating signifying the relevance of TB surveillance system evaluation in improving performance and capacity of the existing system. Hence, this evaluation was conducted in order to determine the gaps and proffer solution to enhance the TB surveillance system performance.

Methods: questionnaires were administered to eight key informants using face-to-face interview method; data obtained was analyzed. Read More

Front Microbiol 2020 25;11:1018. Epub 2020 May 25.

Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.

Buruli ulcer (BU) is a neglected, tropical infectious disease of the skin and the subcutaneous tissue caused by This pathogen has emerged as a new species from a common ancestor with by acquisition of the virulence plasmid pMUM. The plasmid encodes enzymes required for the synthesis of the macrolide toxin mycolactone, which has cytotoxic and immunosuppressive activities. In advanced BU lesions, extracellular clusters of reside in necrotic subcutaneous tissue and are protected from infiltrating leukocytes by the cytotoxic activity of secreted mycolactone. Read More

PLoS One 2020 9;15(6):e0233624. Epub 2020 Jun 9.

Population Health and Best Practices in Health Axis Quebec City University Hospital Research Center Laval University, Hôpital du Saint-Sacrement, Québec, Canada.

Men who have sex with Men (MSM) are a key population in the transmission of Human Immunodeficiency Virus (HIV) infection. In Benin, there is a lack of strategic information to offer appropriate interventions for these populations who live hidden due to their stigmatization and discrimination. The objective is to identify contributing factors that affect HIV incidence in the MSM population. Read More

Br J Dermatol 2020 May 29. Epub 2020 May 29.

ISEM, UMR226, CNRS, Université de Montpellier, IRD, EPHE, Montpellier, France.

Buruli ulcer (BU) is the third most common mycobacterial disease worldwide and affects mainly poor human populations living in tropical and subtropical areas. In 2018, Africa and Australia reported the most cases (2335 and 358 cases, respectively), followed by French Guiana (FG, 5 cases) and Japan (3 cases). Clinical signs of the disease include painless nodules, plaques and edema followed by the development of skin ulcers. Read More

PLoS Negl Trop Dis 2020 May 28;14(5):e0008228. Epub 2020 May 28.

Aix-Marseille Univ., IRD, MEPHI, IHU Méditerranée Infection, Marseille, France.

Background: Mycobacterium ulcerans is an environmental mycobacterium responsible for an opportunistic, noncontagious tropical infection named Buruli ulcer that necrotizes the skin and the subcutaneous tissues. M. ulcerans is thought to penetrate through breached skin after contact with contaminated wetland environments, yet the exact biotopes where M. Read More

PLoS Negl Trop Dis 2020 May 26;14(5):e0008369. Epub 2020 May 26.

Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Background: Buruli ulcer is a chronic ulcerating skin condition, with the highest burden found in Central and West Africa where it disproportionately affects the most vulnerable populations. Treatment is demanding, comprising eight-weeks of daily antibiotics, regular wound care and possible surgical intervention. Treatment completion is key to optimising outcomes, however the degree of and barriers to this are not well understood. Read More

PLoS Negl Trop Dis 2020 May 18;14(5):e0008291. Epub 2020 May 18.

International Foundation for Dermatology, London, United Kingdom.

Background: Skin-related neglected tropical diseases (skin NTDs) occur against a background of a very high prevalence of common skin diseases in sub-Saharan Africa. In this study, we examined the knowledge, attitude and practices (KAP) and the impact of common skin diseases in children living in a leprosy and Buruli ulcer (BU) co-endemic district in a west African country of Côte d'Ivoire, in order to help inform disease control efforts for skin NTDs.

Methods And Principle Findings: Fourteen focus group discussions (FGDs) with schoolchildren, 5 FGDs with parents of a child affected with skin disease(s), and 27 in-depth semi-structured interviews with key personnel were conducted. Read More

J Infect Public Health 2020 Apr 28. Epub 2020 Apr 28.

Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire, UK.

Buruli ulcer and cutaneous leishmaniasis both have the similar cutaneous clinical presentation. Therefore, relying on clinical diagnosis can be challenging. We present a case of 45 years old woman diagnosed with cutaneous leishmaniasis, confirmed by skin biopsy. Read More

PLoS Negl Trop Dis 2020 04 30;14(4):e0008248. Epub 2020 Apr 30.

Medical Department, German Leprosy and TB Relief Association, Enugu State, Nigeria.

Background: There is a dearth of experience in and evidence for cost-effective integrated community-based management of skin neglected tropical diseases (NTDs). The objective of this study was to assess the knowledge, attitude and care-seeking practices including self-care with a view to introducing appropriate community-based interventions for skin NTDs in an endemic setting in Southern Nigeria.

Methods/principal Findings: This exploratory study adopted a mixed-methods design consisting of cross-sectional surveys of community members and health workers using interviewer-administered questionnaires; and focus group discussions (FGDs) with community members, health care workers and patients with NTDs in Anambra State, Nigeria. Read More

Int J Hyperthermia 2020 ;37(1):373-383

Molecular Immunology Unit, Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.

The emergence of antibiotic-resistant bacteria in the last century is alarming and calls for alternative, nonchemical treatment strategies. Thermal medicine uses heat for the treatment of infectious diseases but its use in facultative and obligate intracellular bacteria remains poorly studied. In this review, we summarize previous research on reducing the infectious burden of and by using water-filtered infrared A-radiation (wIRA), a special form of heat radiation with high tissue penetration and low thermal load on the skin surface. Read More

Commun Biol 2020 Apr 20;3(1):177. Epub 2020 Apr 20.

Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France.

Buruli ulcer, caused by Mycobacterium ulcerans and characterized by devastating necrotizing skin lesions, is the third mycobacterial disease worldwide. The role of host genetics in susceptibility to Buruli ulcer has long been suggested. We conduct the first genome-wide association study of Buruli ulcer on a sample of 1524 well characterized patients and controls from rural Benin. Read More

PLoS Negl Trop Dis 2020 04 20;14(4):e0007732. Epub 2020 Apr 20.

Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia.

Background: Buruli ulcer is a necrotising infection of skin and soft tissue caused by Mycobacterium ulcerans (M. ulcerans). Buruli ulcer most often occurs on limbs, and it is hypothesized this is explained by direct exposure to the environment. Read More

Expert Rev Clin Pharmacol 2020 Apr 20;13(4):391-401. Epub 2020 Apr 20.

Departments of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, University of Groningen , Groningen, Netherlands.

Introduction: Pharmacological treatment of Buruli ulcer ( infection; BU) is highly effective, as shown in two randomized trials in Africa.

Areas Covered: We review BU drug treatment - in vitro, in vivo and clinical trials (PubMed: '(Buruli OR (Mycobacterium AND ulcerans)) AND (treatment OR therapy).' We also highlight the pathogenesis of infection that is dominated by mycolactone, a secreted exotoxin, that causes skin and soft tissue necrosis, and impaired immune response and tissue repair. Read More

BMC Public Health 2020 Apr 17;20(1):517. Epub 2020 Apr 17.

Programme National de Lutte contre l'Ulcère de Buruli, Abidjan, Côte d'Ivoire.

Background: Neglected tropical diseases (NTDs) comprise 20 communicable diseases that are prevalent in rural poor and remote communities with less access to the health system. For effective and efficient control, the WHO recommends that affected countries implement integrated control interventions that take into account the different co-endemic NTDs in the same community. However, implementing these integrated interventions involving several diseases with different etiologies, requiring different control approaches and driven by different vertical programs, remains a challenge. Read More

Tuberculosis (Edinb) 2020 Mar 11;121:101914. Epub 2020 Feb 11.

Department of Microbial Infection and Immunity, The Ohio State University, Columbus, OH, USA. Electronic address:

Mycobacteria are important causes of disease in human and animal hosts. Diseases caused by mycobacteria include leprosy, tuberculosis (TB), nontuberculous mycobacteria (NTM) infections and Buruli Ulcer. To better understand and treat mycobacterial disease, clinicians, veterinarians and scientists use a range of discipline-specific approaches to conduct basic and applied research, including conducting epidemiological surveys, patient studies, wildlife sampling, animal models, genetic studies and computational simulations. Read More

PLoS Negl Trop Dis 2020 04 8;14(4):e0008161. Epub 2020 Apr 8.

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

Background: Buruli ulcer (BU) is a necrotizing skin disease, caused by Mycobacterium ulcerans, with poorly understood acquisition risk factors. This review aims at evaluating the importance of individual-sex, age, family ties with history of BU, gene variants-and clinical-Bacillus Calmette-Guérin (BCG) immunization, Human Immunodeficiency Virus (HIV) infection-variables in this process.

Methods: A systematic review was performed considering the following databases: ClinicalTrials. Read More

Hum Genet 2020 Jun 7;139(6-7):847-853. Epub 2020 Apr 7.

Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Paris, France.

Buruli ulcer, the third most common mycobacterial disease worldwide, is caused by Mycobacterium ulcerans and characterized by devastating necrotizing skin lesions. Susceptibility to Buruli ulcer is thought to depend on host genetics, but very few genetic studies have been performed. The identification of a microdeletion on chromosome 8 in a familial form of severe Buruli ulcer suggested a monogenic basis of susceptibility. Read More

PLoS Negl Trop Dis 2020 04 6;14(4):e0008172. Epub 2020 Apr 6.

Deakin University, School of Medicine, Geelong Australia.

Buruli ulcer (BU) is a subcutaneous necrotic infection of the skin caused by Mycobacterium ulcerans. It is the third most common human mycobacterial disease after tuberculosis (TB) and leprosy. The available methods for detection of the bacilli in lesions are microscopic detection, isolation and cultivation of the bacterium, histopathology, and polymerase chain reaction (PCR). Read More

Antimicrob Agents Chemother 2020 May 21;64(6). Epub 2020 May 21.

Center for Tuberculosis Research, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA

Telacebec (Q203) is a new antitubercular drug with extremely potent activity against Here, we explored the treatment-shortening potential of Q203 alone or in combination with rifampin (RIF) in a mouse footpad infection model. The first study compared Q203 at 5 and 10 mg/kg doses alone and with rifampin. Q203 alone rendered most mouse footpads culture negative in 2 weeks. Read More

Lancet 2020 04 12;395(10232):1259-1267. Epub 2020 Mar 12.

Department of Medicine/Infectious Diseases, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands. Electronic address:

Background: Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans infection that damages the skin and subcutis. It is most prevalent in western and central Africa and Australia. Standard antimicrobial treatment with oral rifampicin 10 mg/kg plus intramuscular streptomycin 15 mg/kg once daily for 8 weeks (RS8) is highly effective, but streptomycin injections are painful and potentially harmful. Read More

Lancet 2020 04 12;395(10232):1231-1232. Epub 2020 Mar 12.

Infectious Diseases Department, Austin Health, and University of Melbourne, Heidelberg, VIC 3084, Australia. Electronic address:

Sci Adv 2020 02 26;6(9):eaax7781. Epub 2020 Feb 26.

Equipe ATOMycA, U1232 CRCINA, Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Nantes, Université d'Angers, Angers, France.

Buruli ulcer, a neglected tropical infectious disease, is caused by . Without treatment, its lesions can progress to chronic skin ulcers, but spontaneous healing is observed in 5% of cases, suggesting the possible establishment of a host strategy counteracting the effects of . We reveal here a skin-specific local humoral signature of the spontaneous healing process, associated with a rise in antibody-producing cells and specific recognition of mycolactone by the mouse IgG2a immunoglobulin subclass. Read More

QJM 2020 Mar 4. Epub 2020 Mar 4.

Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan Street, Dongcheng District, Beijing, China.

Mol Immunol 2020 04 29;120:146-163. Epub 2020 Feb 29.

School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW-2751, Australia. Electronic address:

Buruli ulcer is an emerging tissue-necrosis infectious disease, caused by the pathogen Mycobacterium ulcerans, leading to permanent deformity if untreated. Despite this debilitating condition, no specific disease-modifying therapeutics or vaccination is available to date. Therefore, we aimed to design an effective multi-epitope vaccine against M. Read More

Front Immunol 2020 11;11:170. Epub 2020 Feb 11.

Department of Medicine, School of Medicine, University of Washington, Seattle, WA, United States.

Diseases due to mycobacteria, including tuberculosis, leprosy, and Buruli ulcer, rank among the top causes of death and disability worldwide. Animal studies have revealed the importance of T cells in controlling these infections. However, the specific antigens recognized by T cells that confer protective immunity and their associated functions remain to be definitively established. Read More

Annu Rev Anal Chem (Palo Alto Calif) 2020 Jun 28;13(1):315-336. Epub 2020 Feb 28.

Department of Molecular Medicine and Neurobiology, The Scripps Research Institute, La Jolla, California 92037, USA; email:

Technological advances in mass spectrometry have enabled the extensive identification, characterization, and quantification of proteins in any biological system. In disease processes proteins are often altered in response to external stimuli; therefore, proteomics, the large-scale study of proteins and their functions, represents an invaluable tool for understanding the molecular basis of disease. This review highlights the use of mass spectrometry-based proteomics to study the pathogenesis, etiology, and pathology of several neglected tropical diseases (NTDs), a diverse group of disabling diseases primarily associated with poverty in tropical and subtropical regions of the world. Read More

Semin Immunopathol 2020 06 25;42(3):333-353. Epub 2020 Feb 25.

Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.

Mycobacterial pathogens can be categorized into three broad groups: Mycobacterium tuberculosis complex causing tuberculosis, M. leprae and M. lepromatosis causing leprosy, and atypical mycobacteria, or non-tuberculous mycobacteria (NTM), responsible for a wide range of diseases. Read More

Emerg Infect Dis 2020 Mar;26(3):491-503

Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical disease found in rural areas of West and Central Africa. Despite the ongoing efforts to tackle Buruli ulcer epidemics, the environmental reservoir of its pathogen remains elusive, underscoring the need for new approaches to improving disease prevention and management. In our study, we implemented a local-scale spatial clustering model and deciphered the genetic diversity of the bacteria in a small area of Benin where Buruli ulcer is endemic. Read More

PLoS Negl Trop Dis 2020 02 5;14(2):e0008030. Epub 2020 Feb 5.

Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Background: Skin neglected tropical diseases (NTDs) such as Buruli ulcer (BU) and leprosy produce significant stigma and disability. Shared clinical presentations and needs for care present opportunities for integrated case management in co-endemic areas. As global policies are translated into local integrated services, there remains a need to monitor what new configurations of care emerge and how individuals experience them. Read More

Med Sante Trop 2019 Nov;29(4):409-414

Gipse, Villeneuve, France.

Children in developing tropical countries are frequently undernourished. In rural areas, they are also often affected by Buruli ulcers. The treatment of this mutilating disease is sometime long and difficult for malnourished patients. Read More