Reconstructive Plastic Surgery and Burns Unit, Komfo Anokye Teaching Hospital, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Trans R Soc Trop Med Hyg. 2011 Aug;105(8):459-65. doi: 10.1016/j.trstmh.2011.05.003. Epub 2011 Jun 8.
This study examines factors that may enhance the control and holistic treatment of Buruli ulcer in an endemic area of the Ashanti Region in Ghana. A total of 189 Buruli ulcer patients from the Bomfa sub-district were treated at the Global Evangelical Mission Hospital, Apromase-Ashanti, Ghana, from January to December 2005. Diagnosis was based on clinical findings and confirmed by any two positives of Ziehl-Neelson test for acid fast bacilli, polymerase chain reaction and histopathology. Children up to age 14 made up 43.4% of the cases; male: female ratio was 3:2. The mean duration of hospitalization was 77 days and hospital stay was significantly correlated with the time spent at home with the disease prior to admission; also, 76.7% of the cases were late ulcers. Of the 189 patients, 145 (i.e. 76.7%) were treated with antibiotics and surgery which involved excision, skin grafting with or without contracture release. A follow-up survey after the introduction of the psychosocial approach recorded fewer (85) new Buruli ulcer (BU) cases of which, the majority (78.8%, 67) were nodules and only 21.2% (18) were ulcers. Health education plays a major role in the holistic treatment of BU. This paper proposes a further study in other endemic areas on the treatment of BU with emphasis on psychosocial approach for holistic treatment.
本研究旨在探讨在加纳阿散蒂地区的一个布卢利溃疡流行地区增强对该病的控制和整体治疗的因素。2005 年 1 月至 12 月，共有 189 名来自博姆法分区的布卢利溃疡患者在加纳阿普罗马塞-阿散蒂的全球福音使命医院接受治疗。诊断基于临床发现，并通过齐尔-尼尔森酸染色法、聚合酶链反应和组织病理学的任意两项阳性结果进行确认。儿童占病例的 43.4%；男女比例为 3:2。平均住院时间为 77 天，住院时间与入院前在家中患病的时间显著相关；此外，76.7%的病例为晚期溃疡。在 189 名患者中，有 145 名（即 76.7%）接受了抗生素和手术治疗，包括切除、植皮和/或松解挛缩。在引入社会心理方法后的随访调查中，记录到较少的（85）新布卢利溃疡病例，其中大多数（78.8%，67）为结节，只有 21.2%（18）为溃疡。健康教育在布卢利溃疡的整体治疗中起着重要作用。本文提出在其他流行地区进一步研究布卢利溃疡的治疗方法，重点关注整体治疗的社会心理方法。
