title: Diagnosis of Mycobacterium ulcerans infection (Buruli ulcer) at a treatment centre in Ghana: a retrospective analysis of laboratory results of clinically diagnosed cases.
abstract: Clinical diagnosis of Mycobacterium ulcerans infection is currently accepted as sufficient basis for treating the disease. Inadequate laboratory resources in the highly endemic areas of Africa often limit possibilities for in-country confirmation of clinical judgement. We analysed records of 99 Buruli ulcer (BU) patients diagnosed clinically and treated surgically at Amasaman Health Centre in Ghana, for whom post-treatment diagnostic laboratory tests were performed. Comparison of clinical diagnoses with test results obtained by an in-country laboratory on samples of excised tissue showed a high specificity of clinical judgement. Among lesions with three laboratory tests (microscopy for acid fast bacilli, culture and IS2404 polymerase chain reaction) done, 94% tested positive at least once and 83% twice. Thus correct clinical diagnosis of BU by well trained health workers is achievable, although the quality of clinical diagnosis should be monitored by intermittent testing in national reference laboratories. However, being retrospective, this study did not permit sensitivity and negative predictive value analysis.
authors.affiliation: Ghana Health Service, Ministry of Health, Tema, Ghana.
authors.forename: Ernestina
authors.initials: E
authors.lastname: Mensah-Quainoo
authors.forename: Dorothy
authors.initials: D
authors.lastname: Yeboah-Manu
authors.forename: Caroline
authors.initials: C
authors.lastname: Asebi
authors.forename: Francis
authors.initials: F
authors.lastname: Patafuor
authors.forename: David
authors.initials: D
authors.lastname: Ofori-Adjei
authors.forename: Thomas
authors.initials: T
authors.lastname: Junghanss
authors.forename: Gerd
authors.initials: G
authors.lastname: Pluschke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001431:Bacteriological Techniques / Q000379:methods; D054312:Buruli Ulcer / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003470:Culture Media; D004251:DNA Transposable Elements; D019353:Endemic Diseases; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D019911:Mycobacterium ulcerans / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction
chemical_list: D003470:Culture Media; D004251:DNA Transposable Elements