title: On the transmission dynamics of Buruli ulcer in Ghana: Insights through a mathematical model.
abstract: BACKGROUND
  Mycobacterium ulcerans is know to cause the Buruli ulcer. The association between the ulcer and environmental exposure has been documented. However, the epidemiology of the ulcer is not well understood. A hypothesised transmission involves humans being bitten by the water bugs that prey on mollusks, snails and young fishes.
  
  
  METHODS
  In this paper, a model for the transmission of Mycobacterium ulcerans to humans in the presence of a preventive strategy is proposed and analysed. The model equilibria are determined and conditions for the existence of the equilibria established. The model analysis is carried out in terms of the reproduction number [Formula: see text]. The disease free equilibrium is found to be locally asymptotically stable for [Formula: see text] The model is fitted to data from Ghana.
  
  
  RESULTS
  The model is found to exhibit a backward bifurcation and the endemic equilibrium point is globally stable when [Formula: see text] Sensitivity analysis showed that the Buruli ulcer epidemic is highly influenced by the shedding and clearance rates of Mycobacterium ulcerans in the environment. The model is found to fit reasonably well to data from Ghana and projections on the future of the Buruli ulcer epidemic are also made.
  
  
  CONCLUSIONS
  The model reasonably fitted data from Ghana. The fitting process showed data that appeared to have reached a steady state and projections showed that the epidemic levels will remain the same for the projected time. The implications of the results to policy and future management of the disease are discussed.
authors.affiliation: Department of Mathematical Sciences, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa. nyabadzaf@sun.ac.za.
authors.forename: Farai
authors.initials: F
authors.lastname: Nyabadza
authors.affiliation: Department of Mathematics and Statistics, Kumasi Polytechnic, P. O. Box 854, Kumasi, Ghana. ebbonya@yahoo.com.
authors.forename: Ebenezer
authors.initials: E
authors.lastname: Bonyah
mesh_terms: D000465:Algorithms; D000818:Animals; D054312:Buruli Ulcer / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D017753:Ecosystem; D019353:Endemic Diseases; D005869:Ghana / Q000453:epidemiology; D054884:Host-Pathogen Interactions; D006801:Humans; D008962:Models, Theoretical; D019911:Mycobacterium ulcerans / Q000502:physiology*; D015995:Prevalence