Chronic wounds in sierra leone: Searching for buruli ulcer, a ntd caused by mycobacterium ulcerans, at masanga hospital

Abstract

Chronic wounds constitute a significant surgical burden to low- and middle-income countries; however, their aetiology often remains poorly understood. This study improves our understanding of wound aetiology through tissue analysis of chronic leg wounds suspected to be caused by Buruli ulcer (BU). BU is a neglected tropical disease caused by infection with Mycobacterium ulcerans, and remains severely under-researched. There is a lack of testing facilities in regions surrounding endemic countries which makes prevalence difficult to determine, with a particular paucity of data from Sierra Leone (SL). This study identified twenty-one patients with wounds suspected to be caused by BU who presented to Masanga Hospital (Tonkonili District, Sierra Leone) between February and March 2019. Tissue samples were acquired from the wounds and transported to a European tropical health laboratory for analysis. Significant bacterial loads were demonstrated in the samples. However, the gold-standard molecular tests recommended by World Health Organisation (WHO) revealed no cases of BU. These results suggest that BU is not a major cause of chronic wounds in the Northern Province of Sierra Leone. Our conclusions cannot necessarily be generalised to other regions of Sierra Leone, therefore further studies in other geographical districts are required.