title: Simple, Rapid Mycobacterium ulcerans Disease Diagnosis from Clinical Samples by Fluorescence of Mycolactone on Thin Layer Chromatography.
abstract: BACKGROUND
  Mycobacterium ulcerans infection, known as Buruli ulcer, is a disease of the skin and subcutaneous tissues which is an important but neglected tropical disease with its major impact in rural parts of West and Central Africa where facilities for diagnosis and management are poorly developed. We evaluated fluorescent thin layer chromatography (f-TLC) for detection of mycolactone in the laboratory using samples from patients with Buruli ulcer and patients with similar lesions that gave a negative result on PCR for the IS2404 repeat sequence of M. ulcerans.
  
  
  RESULTS
  Mycolactone and DNA extracts from fine needle aspiration (FNA), swabs and biopsy specimen were used to determine the sensitivity and specificity of f-TLC when compared with PCR for the IS2404. For 71 IS2404 PCR positive and 28 PCR negative samples the sensitivity was 73.2% and specificity of 85.7% for f-TLC. The sensitivity was similar for swabs (73%), FNAs (75%) and biopsies (70%).
  
  
  CONCLUSIONS
  We have shown that mycolactone can be detected from M. ulcerans infected skin tissue by f-TLC technique. The technique is simple, easy to perform and read with minimal costs. In this study it was undertaken by a member of the group from each endemic country. It is a potentially implementable tool at the district level after evaluation in larger field studies.
authors.affiliation: Centre de Dépistage et de Traitement de l'Ulcère de Buruli d'Allada, Allada, Bénin.
authors.forename: Anita
authors.initials: A
authors.lastname: Wadagni
authors.affiliation: Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
authors.forename: Michael
authors.initials: M
authors.lastname: Frimpong
authors.affiliation: Institut Médical Evangélique de Kimpese, Kimpese, Democratic Republic of the Congo.
authors.forename: Delphin Mavinga
authors.initials: DM
authors.lastname: Phanzu
authors.affiliation: Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
authors.forename: Anthony
authors.initials: A
authors.lastname: Ablordey
authors.affiliation: Centre de santé Saint michel, Zoukougbeu, Côte d'Ivoire.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Kacou
authors.affiliation: Centre de Dépistage et de Traitement de l'Ulcère de Buruli d'Allada, Allada, Bénin.
authors.forename: Mirabelle
authors.initials: M
authors.lastname: Gbedevi
authors.affiliation: Centre de Diagnostic et de Traitement de l'Ulcère de Buruli de Pobè, Fondation Raoul Follereau, Pobè, Bénin.
authors.forename: Estelle
authors.initials: E
authors.lastname: Marion
authors.affiliation: Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, United States of America.
authors.forename: Yalan
authors.initials: Y
authors.lastname: Xing
authors.affiliation: Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, United States of America.
authors.forename: Vaddela Sudheer
authors.initials: VS
authors.lastname: Babu
authors.affiliation: Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.|Department of Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
authors.forename: Richard Odame
authors.initials: RO
authors.lastname: Phillips
authors.affiliation: St George's University of London, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Wansbrough-Jones
authors.affiliation: Department of Chemistry and Chemical Biology, Harvard University, Cambridge, Massachusetts, United States of America.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Kishi
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Kingsley
authors.initials: K
authors.lastname: Asiedu
mesh_terms: D000293:Adolescent; D000328:Adult; D000350:Africa, Central; D000368:Aged; D001706:Biopsy; D054312:Buruli Ulcer / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D002855:Chromatography, Thin Layer / Q000379:methods*; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D005453:Fluorescence; D006801:Humans; D007223:Infant; D018942:Macrolides / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D019911:Mycobacterium ulcerans / Q000737:chemistry* / Q000235:genetics; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D040521:Subcutaneous Tissue / Q000737:chemistry; D013997:Time Factors; D055815:Young Adult
chemical_list: D018942:Macrolides; C117218:mycolactone