Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.
Identifieur interne : 000337 ( PubMed/Corpus ); précédent : 000336; suivant : 000338Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.
Auteurs : Naa Okaikor Addison ; Stefanie Pfau ; Eric Koka ; Samuel Yaw Aboagye ; Grace Kpeli ; Gerd Pluschke ; Dorothy Yeboah-Manu ; Thomas JunghanssSource :
- PLoS neglected tropical diseases [ 1935-2735 ] ; 2017.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Buruli Ulcer (microbiology), Buruli Ulcer (physiopathology), Buruli Ulcer (therapy), Child, Child, Preschool, Female, Ghana, Humans, Infant, Male, Middle Aged, Mycobacterium ulcerans (genetics), Mycobacterium ulcerans (isolation & purification), Mycobacterium ulcerans (physiology), Primary Health Care (statistics & numerical data), Prospective Studies, Secondary Care Centers (statistics & numerical data), Wound Healing, Young Adult.
- MESH :
- genetics : Mycobacterium ulcerans.
- isolation & purification : Mycobacterium ulcerans.
- microbiology : Buruli Ulcer.
- physiology : Mycobacterium ulcerans.
- physiopathology : Buruli Ulcer.
- statistics & numerical data : Primary Health Care, Secondary Care Centers.
- therapy : Buruli Ulcer.
- Adolescent, Adult, Aged, Child, Child, Preschool, Female, Ghana, Humans, Infant, Male, Middle Aged, Prospective Studies, Wound Healing, Young Adult.
Abstract
Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier.
DOI: 10.1371/journal.pntd.0005331
PubMed: 28245242
Links to Exploration step
pubmed:28245242Le document en format XML
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Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Aboagye, Samuel Yaw" sort="Aboagye, Samuel Yaw" uniqKey="Aboagye S" first="Samuel Yaw" last="Aboagye">Samuel Yaw Aboagye</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Kpeli, Grace" sort="Kpeli, Grace" uniqKey="Kpeli G" first="Grace" last="Kpeli">Grace Kpeli</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Pluschke, Gerd" sort="Pluschke, Gerd" uniqKey="Pluschke G" first="Gerd" last="Pluschke">Gerd Pluschke</name><affiliation><nlm:affiliation>Division of Molecular Immunology, Swiss Tropical and Public Health Institute, Basel, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Yeboah Manu, Dorothy" sort="Yeboah Manu, Dorothy" uniqKey="Yeboah Manu D" first="Dorothy" last="Yeboah-Manu">Dorothy Yeboah-Manu</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Junghanss, Thomas" sort="Junghanss, Thomas" uniqKey="Junghanss T" first="Thomas" last="Junghanss">Thomas Junghanss</name><affiliation><nlm:affiliation>Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28245242</idno><idno type="pmid">28245242</idno><idno type="doi">10.1371/journal.pntd.0005331</idno><idno type="wicri:Area/PubMed/Corpus">000337</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000337</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.</title><author><name sortKey="Addison, Naa Okaikor" sort="Addison, Naa Okaikor" uniqKey="Addison N" first="Naa Okaikor" last="Addison">Naa Okaikor Addison</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Pfau, Stefanie" sort="Pfau, Stefanie" uniqKey="Pfau S" first="Stefanie" last="Pfau">Stefanie Pfau</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Koka, Eric" sort="Koka, Eric" uniqKey="Koka E" first="Eric" last="Koka">Eric Koka</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Aboagye, Samuel Yaw" sort="Aboagye, Samuel Yaw" uniqKey="Aboagye S" first="Samuel Yaw" last="Aboagye">Samuel Yaw Aboagye</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Kpeli, Grace" sort="Kpeli, Grace" uniqKey="Kpeli G" first="Grace" last="Kpeli">Grace Kpeli</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Pluschke, Gerd" sort="Pluschke, Gerd" uniqKey="Pluschke G" first="Gerd" last="Pluschke">Gerd Pluschke</name><affiliation><nlm:affiliation>Division of Molecular Immunology, Swiss Tropical and Public Health Institute, Basel, Switzerland.</nlm:affiliation></affiliation></author><author><name sortKey="Yeboah Manu, Dorothy" sort="Yeboah Manu, Dorothy" uniqKey="Yeboah Manu D" first="Dorothy" last="Yeboah-Manu">Dorothy Yeboah-Manu</name><affiliation><nlm:affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</nlm:affiliation></affiliation></author><author><name sortKey="Junghanss, Thomas" sort="Junghanss, Thomas" uniqKey="Junghanss T" first="Thomas" last="Junghanss">Thomas Junghanss</name><affiliation><nlm:affiliation>Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.</nlm:affiliation></affiliation></author></analytic><series><title level="j">PLoS neglected tropical diseases</title><idno type="eISSN">1935-2735</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Buruli Ulcer (microbiology)</term><term>Buruli Ulcer (physiopathology)</term><term>Buruli Ulcer (therapy)</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Ghana</term><term>Humans</term><term>Infant</term><term>Male</term><term>Middle Aged</term><term>Mycobacterium ulcerans (genetics)</term><term>Mycobacterium ulcerans (isolation & purification)</term><term>Mycobacterium ulcerans (physiology)</term><term>Primary Health Care (statistics & numerical data)</term><term>Prospective Studies</term><term>Secondary Care Centers (statistics & numerical data)</term><term>Wound Healing</term><term>Young Adult</term></keywords><keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Mycobacterium ulcerans</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Mycobacterium ulcerans</term></keywords><keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Buruli Ulcer</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Mycobacterium ulcerans</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Buruli Ulcer</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Primary Health Care</term><term>Secondary Care Centers</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Buruli Ulcer</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Ghana</term><term>Humans</term><term>Infant</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Wound Healing</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28245242</PMID><DateCreated><Year>2017</Year><Month>02</Month><Day>28</Day></DateCreated><DateCompleted><Year>2017</Year><Month>07</Month><Day>14</Day></DateCompleted><DateRevised><Year>2017</Year><Month>07</Month><Day>14</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1935-2735</ISSN><JournalIssue CitedMedium="Internet"><Volume>11</Volume><Issue>2</Issue><PubDate><Year>2017</Year><Month>Feb</Month></PubDate></JournalIssue><Title>PLoS neglected tropical diseases</Title><ISOAbbreviation>PLoS Negl Trop Dis</ISOAbbreviation></Journal><ArticleTitle>Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana.</ArticleTitle><Pagination><MedlinePgn>e0005331</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pntd.0005331</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Beyond Mycobacterium ulcerans-specific therapy, sound general wound management is required for successful management of Buruli ulcer (BU) patients which places them among the large and diverse group of patients in poor countries with a broken skin barrier.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Clinically BU suspicious patients were enrolled between October 2013 and August 2015 at a primary health care (PHC) center and a municipal hospital, secondary health care (SHC) center in Ghana. All patients were IS2404 PCR tested and divided into IS2404 PCR positive and negative groups. The course of wound healing was prospectively investigated including predictors of wound closure and assessment of infrastructure, supply and health staff performance.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">53 IS2404 PCR positive patients-31 at the PHC center and 22 at the SHC center were enrolled-and additionally, 80 clinically BU suspicious, IS2404 PCR negative patients at the PHC center. The majority of the skin ulcers at the PHC center closed, without the need for surgical intervention (86.7%) compared to 40% at the SHC center, where the majority required split-skin grafting (75%) or excision (12.5%). Only 9% of wounds at the PHC center, but 50% at the SHC center were complicated by bacterial infection. The majority of patients, 54.8% at the PHC center and 68.4% at the SHC center, experienced wound pain, mostly severe and associated with wound dressing. Failure of ulcers to heal was reliably predicted by wound area reduction between week 2 and 4 after initiation of treatment in 75% at the PHC center, and 90% at the SHC center. Obvious reasons for arrested wound healing or deterioration of wound were missed additional severe pathology; at the PHC center (chronic osteomyelitis, chronic lymphedema, squamous cell carcinoma) and at the SHC center (malignant ulceration, chronic lymphedema) in addition to hygiene and wound care deficiencies. When clinically suspicious, but IS2404 PCR negative patients were recaptured in the community, 76/77 (98.7%) of analyzed wounds were either completely closed (85.7%) or almost closed (13%). Five percent were found to have important missed severe pathology (chronic osteomyelitis, ossified fibroma and suspected malignancy).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The wounds of most BU patients attending the primary health care level can be adequately managed. Additionally, the patients are closer to their families and means of livelihood. Non-healing wounds can be predicted by wound area reduction between 2 to 4 weeks after initiation of treatment. Patients with clinically BU suspicious, but PCR negative ulcers need to be followed up to capture missed diagnoses.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Addison</LastName><ForeName>Naa Okaikor</ForeName><Initials>NO</Initials><AffiliationInfo><Affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Microbiology, Korle-Bu Teaching Hospital, Accra, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pfau</LastName><ForeName>Stefanie</ForeName><Initials>S</Initials><Identifier Source="ORCID">http://orcid.org/0000-0003-2658-3980</Identifier><AffiliationInfo><Affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koka</LastName><ForeName>Eric</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Sociology and Anthropology, University of Cape-Coast, Cape-Coast, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aboagye</LastName><ForeName>Samuel Yaw</ForeName><Initials>SY</Initials><AffiliationInfo><Affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kpeli</LastName><ForeName>Grace</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Molecular Immunology, Swiss Tropical and Public Health Institute, Basel, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>University of Basel, Basel, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pluschke</LastName><ForeName>Gerd</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Division of Molecular Immunology, Swiss Tropical and Public Health Institute, Basel, Switzerland.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>University of Basel, Basel, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yeboah-Manu</LastName><ForeName>Dorothy</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Junghanss</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Section Clinical Tropical Medicine, Heidelberg University Hospital, Heidelberg, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>02</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>PLoS Negl Trop Dis</MedlineTA><NlmUniqueID>101291488</NlmUniqueID><ISSNLinking>1935-2727</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>PLoS One. 2015 Jun 01;10(6):e0119926</RefSource><PMID Version="1">26030764</PMID></CommentsCorrections><CommentsCorrections 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MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005869" MajorTopicYN="N">Ghana</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019911" MajorTopicYN="N">Mycobacterium ulcerans</DescriptorName><QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName><QualifierName UI="Q000302" MajorTopicYN="N">isolation & purification</QualifierName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D063728" MajorTopicYN="N">Secondary Care Centers</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014945" MajorTopicYN="N">Wound Healing</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>08</Month><Day>25</Day></PubMedPubDate><PubMedPubDate 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