title: Spatial dependency of Buruli ulcer prevalence on arsenic-enriched domains in Amansie West District, Ghana: implications for arsenic mediation in Mycobacterium ulcerans infection.
abstract: BACKGROUND: In 1998, the World Health Organization recognized Buruli ulcer (BU), a human skin disease caused by Mycobacterium ulcerans (MU), as the third most prevalent mycobacterial disease. In Ghana, there have been more than 2000 reported cases in the last ten years; outbreaks have occurred in at least 90 of its 110 administrative districts. In one of the worst affected districts, Amansie West, there are arsenic-enriched surface environments resulting from the oxidation of arsenic-bearing minerals, occurring naturally in mineral deposits. RESULTS: Proximity analysis, carried out to determine spatial relationships between BU-affected areas and arsenic-enriched farmlands and arsenic-enriched drainage channels in the Amansie West District, showed that mean BU prevalence in settlements along arsenic-enriched drainages and within arsenic-enriched farmlands is greater than elsewhere. Furthermore, mean BU prevalence is greater along arsenic-enriched drainages than within arsenic-enriched farmlands. CONCLUSION: The results suggest that arsenic in the environment may play a contributory role in MU infection.
authors.affiliation: International Institute for Geo-information Science and Earth Observation (ITC), Enschede, P,O, Box 6, 7500 AA The Netherlands. duker@itc.nl.
authors.forename: Alfred A
authors.initials: AA
authors.lastname: Duker
authors.forename: Emmanuel Jm
authors.initials: EJ
authors.lastname: Carranza
authors.forename: Martin
authors.initials: M
authors.lastname: Hale