Complications related to the management of mycobacterium ulcerans disease in Bénin: A plea for early case detection

Buruli ulcer is infectious neglected tropical disease caused by Mycobacterium ulcerans. Usually patients report to the hospital at an advanced stage of the disease resulting in prolonged hospital admission, eventually, severe functional limitations and heavy and socio-economic burden. The mode of transmission is still unknown. Early case detection associated with specific antimicrobial treatment is the main strategy to control this disease. This thesis aims to study the prevention of Buruli ulcer. It especially focuses on the efficacy of community health volunteers in the early case detection, the rational use of nonspecific antibiotics for prophylaxis after surgery or in case of suspected secondary infection, the paradoxical reaction and the functional limitations after specific antibiotic treatment in patients affected by Buruli ulcer. Our findings will impact the direction of future control activities in Buruli ulcer disease. Strengths and limitations of the studies contained in this thesis as well as direction for future research are presented. To conclude, it appears that of all strategies currently explored and discussed here, an optimized strategy for early case detection has the highest priority since it will reduce the • duration of treatment, • secondary infection, • paradoxical reaction, • permanent functional limitation, • direct and indirect financial burden and, • overall suffering caused by this diseases

A global call for action to tackle skin-related neglected tropical diseases (skin NTDs) through integration: An ambitious step change.

On 8 June 2022, the World Health Organization (WHO) released pivotal guidance, "Ending the neglect to attain the Sustainable Development Goals: A strategic framework for integrated control and management of skin-related neglected tropical diseases." Skin-related neglected tropical diseases, or skin NTDs, comprise a group of NTDs that produce signs and symptoms on the skin and include at least 9 diseases or disease groups. Moving away from disease-specific approaches, it is anticipated that synergies will be identified and integrated building on this shared feature, where possible, to achieve a greater health impact. This paper intends to draw attention to the prospects created by this scheme. The framework is a key basis for a proposal produced by WHO dedicated to skin NTD integration and describes the practical opportunities for this evolving strategy. It underlines the wider health benefits that will follow, thus working towards Universal Health Coverage and skin health for all