Buruli ulcer

A neglected but treatable disease that unnecessarily scars African children for life

Buruli ulcer, caused by infection with Mycobacterium ulcerans, is unfamiliar because it is common only among children in rural tropical areas, mainly in west Africa. Ghana, Côte d'Ivoire, and Benin are among the worst affected.1 It is named Buruli after a county in Uganda. It is an easily treatable disease as common as tuberculosis in areas where it is endemic.^w1In endemic areas in Ghana point prevalence has been estimated at 150-180/100 000 population, and in southern Benin, a detection rate of 20/100 000 per year has been reported.^{w2 w3}Lack of treatment leaves children with large disfiguring scars and occasionally with joint deformities, loss of sight, loss of breast or scrotal tissue, and even amputations.

Ulcers (figure) can reach a dramatic size, particularly in the oedematous form, which spreads rapidly over large parts of the limbs, trunk, or head. How infection is transmitted remains …