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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
A stepwise approach to the laboratory diagnosis of Buruli ulcer disease
Tropical Medicine and International Health, Volume 12, No. 1, Year 2007
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Description
Objective: In view of technical and financial limitations in areas of endemicity, the current practice and recommendations for the laboratory diagnosis of Buruli ulcer disease (BUD) may have to be reconsidered. We reviewed diagnostic results in order to explore options for a modified, more practicable, cost-effective and timely approach to the laboratory diagnosis of BUD. Methods: Diagnostic specimens from 161 clinically diagnosed BUD patients from four different treatment centres in Ghana were subjected to laboratory analysis. The positivity rates of the laboratory assays were compared. Results: The number of laboratory-confirmed clinically diagnosed BUD cases with one positive confirmative test was 20% higher than that with two positive confirmative tests. The specificity of microscopy (MIC) and PCR was 96.6% and 100%, respectively. Subsequent analysis of specimens from surgically excised pre-ulcerative tissue-by-tissue MIC and tissue PCR rendered 65% laboratory-confirmed BUD cases. Subsequent analysis of diagnostic swabs from ulcerative lesions by swab smear MIC and swab PCR rendered 70% of laboratory-confirmed BUD cases. Conclusions: The specificity of the diagnostic tests used in this study suggests that one positive diagnostic test may be considered sufficient for the laboratory confirmation of BUD. Subsequent application of different diagnostic tests rendered a laboratory confirmation of 65% pre-ulcerative and of 70% ulcerative lesions. Implementation of a stepwise, subsequent analysis of diagnostic specimens will result in considerable cost saving compared with simultaneous testing of specimens by several diagnostic assays. © 2007 Blackwell Publishing Ltd.
Authors & Co-Authors
Bretzel, Gisela
Germany, Munich
Ludwig-maximilians-universität München
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Siegmund, Vera
Germany, Munich
Ludwig-maximilians-universität München
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Nitschke, Jörg
Germany, Munich
Ludwig-maximilians-universität München
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Herbinger, Karl Heinz
Germany, Munich
Ludwig-maximilians-universität München
Thompson, William A.
Ghana, Agogo
Agogo Presbyterian Hospital
Klutse, Erasmus Y.
Ghana
Dunkwa Governmental Hospital
Crofts, K.
United States, Provo
Humanitarian Aid Relief Team (hart)
Massavon, William
Ghana
Goaso Hospital
Etuaful, Samuel N.
Ghana
St. Martin's Catholic Hospital
Thompson, Ruth
Ghana, Kumasi
Kumasi Centre for Collaborative Research in Tropical Medicine Kccr
Asamoah-Opare, K.
Ghana, Kumasi
Kumasi Centre for Collaborative Research in Tropical Medicine Kccr
Rácz, Paul
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Vloten, F.
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Van Berberich, C.
Ghana, Kumasi
Kumasi Centre for Collaborative Research in Tropical Medicine Kccr
Kruppa, Thomas Florian
Ghana, Kumasi
Kumasi Centre for Collaborative Research in Tropical Medicine Kccr
Ampadu, Edwin O.
Ghana, Accra
National Buruli Ulcer Control Programme
Fleischer, Bernhard
Germany, Hamburg
Bernhard Nocht Institut Fur Tropenmedizin Hamburg
Adjei, Ohene
Ghana, Kumasi
Kumasi Centre for Collaborative Research in Tropical Medicine Kccr
Statistics
Citations: 37
Authors: 18
Affiliations: 9
Identifiers
Doi:
10.1111/j.1365-3156.2006.01761.x
ISSN:
13602276
e-ISSN:
13653156
Study Locations
Ghana