Sizaire Vinciane, Nackers Fabienne, Comte Eric, Portaels Françoise
Médecins Sans Frontières, London, UK.
Lancet Infect Dis. 2006 May;6(5):288-96. doi: 10.1016/S1473-3099(06)70464-9.
The skin disease Buruli ulcer, caused by Mycobacterium ulcerans, is the third most common mycobacterial disease after tuberculosis and leprosy and mainly affects remote rural African communities. Although the disease is known to be linked to contaminated water, the mode of transmission is not yet understood, which makes it difficult to propose control interventions. The disease is usually detected in its later stages, when it has caused substantial damage and disability. Surgery remains the treatment of choice. Although easy and effective in the early stages of the disease, treatment requires extended excisions and long hospitalisation for the advanced forms of the disease. Currently, no antibiotic treatment has proven effective for all forms of M ulcerans infection and research into a new vaccine is urgently needed. While the scientific community works on developing non-invasive and rapid diagnostic tools, the governments of endemic countries should implement active case finding and health education strategies in their affected communities to detect the disease in its early stages. We review the diagnosis, treatment, and control of Buruli ulcer and list priorities for research and development.
由溃疡分枝杆菌引起的皮肤病布鲁里溃疡是继结核病和麻风病之后的第三大常见分枝杆菌病，主要影响非洲偏远农村社区。尽管已知该疾病与受污染的水有关，但其传播方式尚不清楚，这使得难以提出控制干预措施。该疾病通常在后期才被发现，此时它已造成严重损害和残疾。手术仍然是首选治疗方法。虽然在疾病早期简单有效，但对于晚期疾病，治疗需要广泛切除和长时间住院。目前，尚无抗生素治疗被证明对所有形式的溃疡分枝杆菌感染均有效，因此迫切需要研究新疫苗。在科学界致力于开发非侵入性快速诊断工具的同时，流行国家的政府应在其受影响社区实施主动病例发现和健康教育策略，以便在疾病早期进行检测。我们综述了布鲁里溃疡的诊断、治疗和控制，并列出了研发重点。
