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Improving clinical and epidemiological predictors of Buruli ulcer

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dc.contributor.author Ayelo, G. A. en_US
dc.contributor.author Sopoh, G. E. en_US
dc.contributor.author Houezo, J. G. en_US
dc.contributor.author Fiodessihoue, R. en_US
dc.contributor.author Affolabi, D. en_US
dc.contributor.author Dossou, A. D. en_US
dc.contributor.author Barogui, Y. T. en_US
dc.contributor.author Wadagni, A. A. C. en_US
dc.contributor.author Agossadou, D. C. en_US
dc.contributor.author Hasker, E. en_US
dc.contributor.author Portaels, F. en_US
dc.contributor.author de Jong, B. C. en_US
dc.contributor.author Eddyani, M. en_US
dc.date.accessioned 2019-06-04T12:20:58Z
dc.date.available 2019-06-04T12:20:58Z
dc.date.issued 2018 en_US
dc.identifier.issn 1935-2727 en_US
dc.identifier.doi http://dx.doi.org/10.1371/journal.pntd.0006713 en_US
dc.identifier.other http://lib.itg.be/pdf/itg/2018/2018pntde0006713.pdf en_US
dc.identifier.other 11 pp. en_US
dc.identifier.other 44 en_US
dc.identifier.other ITG-H10A; ITG-H11X; ITG-H12A; ITG-HLA; MULTI; DPH; U-ECTD; DBM; U-MYCOB; JIF; DOI; PDF; OAJ; E-only; Abstract; ITMPUB; DSPACE65 en_US
dc.identifier.uri http://hdl.handle.net/10390/10658
dc.description.abstract BACKGROUND: Buruli ulcer (BU) is a chronic necrotizing infectious skin disease caused by Mycobacterium ulcerans. The treatment with BU-specific antibiotics is initiated after clinical suspicion based on the WHO clinical and epidemiological criteria. This study aimed to estimate the predictive values of these criteria and how they could be improved. METHODOLOGY/PRINCIPAL FINDINGS: A total of 224 consecutive patients presenting with skin and soft tissue lesions that could be compatible with BU, including those recognized as unlikely BU by experienced clinicians, were recruited in two BU treatment centers in southern Benin between March 2012 and March 2015. For every participant, the WHO and four additional epidemiological and clinical diagnostic criteria were recorded. For microbiological confirmation, direct smear examination and IS2404 PCR were performed. We fitted a logistic regression model with PCR positivity for BU confirmation as outcome variable. On univariate analysis, most of the clinical and epidemiological WHO criteria were associated with a positive PCR result. However, lesions on the lower limbs and WHO category 3 lesions were rather associated with a negative PCR result (respectively OR: 0.4, 95%CI: 0.3-0.8; OR: 0.5, 95%IC: 0.3-0.9). Among the additional characteristics studied, the characteristic smell of BU was strongest associated with a positive PCR result (OR = 16.4; 95%CI = 7.5-35.6). CONCLUSION/SIGNIFICANCE: The WHO diagnostic criteria could be improved upon by differentiating between lesions on the upper and lower limbs and by including lesion size and the characteristic smell recognized by experienced clinicians. en_US
dc.language English en_US
dc.relation.uri http://www.ncbi.nlm.nih.gov/pubmed/30080870 en_US
dc.subject Mycobacterium ulcerans en_US
dc.subject Buruli ulcer en_US
dc.subject Bacterial diseases en_US
dc.subject Skin diseases en_US
dc.subject Predictors en_US
dc.subject Predictive value en_US
dc.title Improving clinical and epidemiological predictors of Buruli ulcer en_US
dc.type Article-E en_US
dc.citation.issue 8 en_US
dc.citation.jtitle PLoS Neglected Tropical Diseases en_US
dc.citation.volume 12 en_US
dc.citation.pages e0006713 en_US
dc.citation.abbreviation PLoS Negl Trop Dis en_US


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