Fukunishi Y
National Sanatorium, Matuoka Hoyo-en, Japan.
Nihon Hansenbyo Gakkai Zasshi. 1999 Nov;68(3):175-84. doi: 10.5025/hansen.68.175.
Recently, Buruli ulcer is emerging from the West and Central African countries. The disease come up with necrotizing and immno-suppressive type ulcer in the skin, subcutaneous tissue and bone, infected by Mycobacterium ulcerans, and shows indolent chronic course as mycobacterial infection, like tuberculosis and Hansen's disease. After the transmission to human, the lesion is usually single and begin as firm, painless, subcutaneous nodule and on any area of human body skin, though most frequently on lower limbs. In countries of West Africa, it is suspected that the disease should be spreading most widely in Ghana. During April and June 1999, Ghana Health Service pick up the new patients by nation-wide examination. The author visited Ghana twice at March and September 1999 and made on-the-spot inspections not only at a community and Ga district Health Service Center in Accra region but also at St. Martin's hospital in Agroyesum, Amanse west district, Ashanti region. At the time, the author did see the present state of Buruli ulcer, i.e. health and medical enlightenment. This report, includes the results due to undergoing nation-wide examination on Buruli ulcer at 2 District in Ghana (List 1 and 2), the present states of the patients and the enlightenment provided by the staffs of Ga district Health Service Center (Photografs 1-14). Staffs working for WHO and Ghana Health Service are tackling to Buruli ulcer problems, but conditions of the patients are very hard because these patients must live in tropical wetlands, poor health, poor medical and poor economic conditions.
最近,布氏杆菌溃疡正从西非和中非国家出现。该疾病由溃疡分枝杆菌感染引起,在皮肤、皮下组织和骨骼中出现坏死性和免疫抑制性溃疡,呈现出像结核病和麻风病那样的慢性病程。传播给人类后,病变通常为单个,起初是坚实、无痛的皮下结节,可出现在人体皮肤的任何部位,不过最常见于下肢。在西非国家,人们怀疑该病在加纳传播最为广泛。1999年4月至6月期间,加纳卫生服务部门通过全国范围的检查发现了新患者。作者于1999年3月和9月两次访问加纳,不仅在阿克拉地区的一个社区和加区卫生服务中心,还在阿散蒂地区阿曼西西区阿格罗耶苏姆的圣马丁医院进行了实地考察。当时,作者确实看到了布氏杆菌溃疡的现状,即健康和医学宣传情况。本报告包括在加纳两个地区对布氏杆菌溃疡进行全国范围检查的结果(列表1和2)、患者的现状以及加区卫生服务中心工作人员提供的宣传情况(照片1 - 14)。为世界卫生组织和加纳卫生服务部门工作的人员正在应对布氏杆菌溃疡问题,但患者的状况非常艰难,因为这些患者必须生活在热带湿地,健康状况差、医疗条件差且经济条件差。