title: Burden and Historical Trend of Buruli Ulcer Prevalence in Selected Communities along the Offin River of Ghana.
abstract: Buruli ulcer (BU) is a neglected tropical skin disease caused by Mycobacterium ulcerans with more than two thirds of the global cases reported in West Africa. A nationwide active BU case search conducted in 1999 identified two health districts along the Offin River as two of the three most endemic districts in Ghana. Based on recent anecdotal accounts that transmission is unstable along the Offin River, we conducted from March to June 2013 an exhaustive household survey and active case search in 13 selected communities within a five-kilometer radius along the Offin River. The overall prevalence of BU was 2.3% among the surveyed population of 20,390 inhabitants and 477 of the total 480 cases detected (99.4%) were historical (healed) cases. By estimating the year of occurrence for each case per community and taking into account available passive surveillance records of health facilities and the District Health Directorate, we observed a general trend of continuous emergence of cases in communities located midstream the Offin River whereas downstream communities showed more sporadic patterns. We monitored the incidence of cases after the survey and recorded a cumulative incidence rate of 0.04% for the 13 communities over a 17-month active surveillance period from August 2013 to December 2014. Our data reveal an overall decline in BU incidence along the Offin River similar to the general decline in BU incidence in recent years reported by the World Health Organization for West Africa.
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.|Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Kobina Assan
authors.initials: KA
authors.lastname: Ampah
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Prince
authors.initials: P
authors.lastname: Asare
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Daniel De-Graft
authors.initials: DD
authors.lastname: Binnah
authors.affiliation: Department of Earth Science, University of Ghana, Legon, Ghana.
authors.forename: Samuel
authors.initials: S
authors.lastname: Maccaulley
authors.affiliation: National Buruli Ulcer Control Programme, Disease Control Unit- GHS, Accra, Ghana.
authors.forename: William
authors.initials: W
authors.lastname: Opare
authors.affiliation: Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Katharina
authors.initials: K
authors.lastname: Röltgen
authors.affiliation: Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland.|University of Basel, Basel, Switzerland.
authors.forename: Gerd
authors.initials: G
authors.lastname: Pluschke
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Yeboah-Manu
mesh_terms: D054312:Buruli Ulcer / Q000453:epidemiology*; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D015995:Prevalence; D045483:Rivers