Global Emergence of Buruli Ulcer

Excerpt

Rapid ecological changes, underpinned by human activities or climate change, influence the geographic distribution of emerging pathogens (Jones et al. 2008). Recent works on Buruli ulcer (BU) emergence, a neglected tropical disease of the skin and soft tissue, linked the infectious agent Mycobacterium ulcerans to deforestation of primary forests for agriculture and mining activities (Combe et al. 2017). A clustering of BU cases in the alluvial gold mining towns of Kakerifu and Kasongo was observed in Democratic Republic of Congo (Janssens et al. 2005). In addition, the increase of artisanal gold mining in the Birimian Greenstone belt during the 1980s correlated with the emergence of BU in West Africa (van der Werf et al. 1989). In Ghana, the Amansie West district, where the Ashanti gold mines are located, was the most BU endemic region with 150.8 cases per 100,000 people reported in 1999 (Amofah et al. 2002). The Ghanaian districts exhibiting Birimian meta-sedimentary rock, an Archean greenstone rich in arsenopyrites, were found more susceptible to BU (Mantey et al. 2012). The authors hypothesized that arsenic-enriched water in these regions facilitates M. ulcerans to establish BU by down-regulation of the immune system in local human populations. …