Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
WHO Collaborating Center for Leishmaniasis, Instituto de Salud Carlos III, CIBERINFEC, Madrid, Spain.
PLoS One. 2023 Sep 27;18(9):e0292034. doi: 10.1371/journal.pone.0292034. eCollection 2023.
A recent study detected cutaneous leishmaniasis (CL) in 31.9% of persons with skin ulcers in the Oti Region of Ghana, resulting in a need to investigate other potential causes of the unexplained skin ulcers.
METHODOLOGY/PRINCIPAL FINDINGS: A community based cross-sectional study was conducted in the Oti region to investigate skin ulcers of undetermined aetiologies. To confirm a diagnosis of cutaneous leishmaniasis, Buruli ulcer, Haemophilus ducreyi ulcers, or yaws, DNA obtained from each patient skin ulcer sample was systematically subjected to polymerase chain reaction (PCR) for Leishmania spp., Mycobacterium ulcerans, Haemophilus ducreyi, and Treponema pallidum sub species pertenue. A total of 101 skin ulcer samples were obtained from 101 persons. Co-infection of more than one organism was observed in 68.3% of the samples. Forty (39.6%) participants had a positive result for Leishmania spp., 68 (67.3%) for Treponema pallidum sub. Sp. pertenue, and 74 (73.3%) for H. ducreyi. Twenty (19.8%) of the patient ulcers were simultaneously infected with Leishmania spp., Treponema pallidum sub. Sp. pertenue, and H. ducreyi. None of the patients' lesions yielded a positive result for Mycobacterium ulcerans.
CONCLUSIONS/SIGNIFICANCE: This study detected single and mixed occurrence of the causative organisms of CL, yaws, and H. ducreyi cutaneous ulcers in CL endemic communities of the Oti Region in Ghana. These findings emphasize the importance of integrating multiple skin diseases on a common research platform and calls for the development of a comprehensive guideline for diagnosing and treating tropical ulcers in the study areas.
最近的一项研究在加纳奥蒂地区发现，31.9%的皮肤溃疡患者患有皮肤利什曼病（CL），这导致需要调查其他不明原因皮肤溃疡的潜在原因。
方法/主要发现：在奥蒂地区进行了一项基于社区的横断面研究，以调查病因不明的皮肤溃疡。为了确认皮肤利什曼病、溃疡分枝杆菌溃疡、杜克雷嗜血杆菌溃疡或雅司病的诊断，从每位患者的皮肤溃疡样本中获得的 DNA 被系统地进行聚合酶链反应（PCR），以检测利什曼原虫、溃疡分枝杆菌、杜克雷嗜血杆菌和苍白密螺旋体亚种。共从 101 名患者中获得 101 个皮肤溃疡样本。在 68.3%的样本中观察到一种以上生物体的合并感染。40 名（39.6%）参与者的利什曼原虫检测结果为阳性，68 名（67.3%）为苍白密螺旋体亚种，74 名（73.3%）为杜克雷嗜血杆菌。20 名（19.8%）患者的溃疡同时感染了利什曼原虫、苍白密螺旋体亚种和杜克雷嗜血杆菌。没有患者的病变对溃疡分枝杆菌产生阳性结果。
结论/意义：本研究在加纳奥蒂地区的 CL 流行社区中检测到了 CL、雅司病和杜克雷嗜血杆菌皮肤溃疡的单一和混合病原体。这些发现强调了在共同研究平台上整合多种皮肤病的重要性，并呼吁在研究区域制定综合的热带溃疡诊断和治疗指南。
