Serum creatinine levels in children at long term follow-up.

<p>Mean (SD) serum creatinine concentrations of children (under 16 at the time of treatment), measured at baseline, after 8 weeks of treatment and at long term follow-up. SR8 = participants in the 8 week Streptomycin/Rifampicin group. SR4/CR4 = participants in the 4 week Streptomycin/Rifampicin plus 4 week Clarithromycin/Rifampicin group. The differences between the two groups were tested with the students t-test. All differences ns (<i>N</i> = 84).</p

Hearing thresholds of adults at long term follow-up.

<p>Mean hearing thresholds of adults (16 or older at the time of treatment) in dB averaged over both ears. The shaded area represents the area used in understanding human speech (Pascoe, 1980) <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002739#pntd.0002739-Pascoe1" target="_blank">[37]</a>. SR8 = participants in the 8 week Streptomycin/Rifampicin group. SR4/CR4 = participants in the 4 week Streptomycin/Rifampicin plus 4 week Clarithromycin/Rifampicin group. The Differences between the two groups were tested with the Mann-Whitney U test, 1-tailed. * = p<0.05, ** = p<0.001.</p

Hearing thresholds of children at long term follow-up.

<p>Mean hearing thresholds of children (under 16 at the time of treatment) in dB averaged over both ears. The shaded area represents the area used in understanding human speech (Pascoe, 1980) <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0002739#pntd.0002739-Pascoe1" target="_blank">[37]</a>. SR8 = participants in the 8 week Streptomycin/Rifampicin group. SR4/CR4 = participants in the 4 week Streptomycin/Rifampicin plus 4 week Clarithromycin/Rifampicin group. The Differences between the two groups were tested with the Mann-Whitney U test, all differences were ns.</p

Univariate associations with nephrotoxicity during treatment.

<p>All <i>P</i> values are 1-tailed except for sex.</p

Clinical details for BU patients enrolled in the study.

<p>*STR = WHO recommended treatment of 8 weeks streptomycin and rifampicin;</p>#<p>‘Category’ refers to WHO clinical severity scoring system for BU E = edematous, N = nodule, Q = Plaque, U = ulcerative.</p

Details for household contacts enrolled in the study.

<p>Details for household contacts enrolled in the study.</p

Clinical presentation of three, confirmed BU patients enrolled in this study showing: (A) nodule of the right knee; (B) ulcer of the right elbow; (C) ulcer of the left hand at diagnosis; and (D) ulcer of the right elbow 6 weeks post diagnosis and commence

<p>Clinical presentation of three, confirmed BU patients enrolled in this study showing: (A) nodule of the right knee; (B) ulcer of the right elbow; (C) ulcer of the left hand at diagnosis; and (D) ulcer of the right elbow 6 weeks post diagnosis and commencement of SR8 with surgical intervention.</p

Cytotoxicity of ASL from human Mu lesions on human embryonic lung fibroblasts.

<p>Cytotoxicity after 48 h culture was assessed using an MTT assay. Negative control 1 is untreated cells, negative control 2 is ASL from uninfected skin. Positive control was purified mycolactone at a concentration of 5 µg/ml. Significant cytotoxicity was observed with all patient samples with ***p<0.001 compared to negative control 1. The apparent difference in percentage cytotoxicity between 5 untreated and 5 antibiotic treated lesions was not statistically significant. HELF cells were treated in quadruplicates and cytotoxicity determined in at least 2 independent experiments. Data are shown as a percentage of untreated cells (negative control 1). Error bars are ±SEM of duplicate assays.</p

Patient characteristics, diagnostic data and treatment status.

*<p>Antibiotic treatment was with streptomycin injection15 mg/kg and oral rifampicin 10 mg/kg daily.</p

Detection of mycolactone by mass spectrometry.

<p>A. MS analysis of ASL from Mu infected human skin showing a molecule with m/z 765.5 which represents the sodium adduct of mycolactone A/B [M+Na⁺]. B. MS-MS analysis of this ion produced the core lactone ring of mycolactone with m/z 429.4 and the polyketide side chain of mycolactone A/B with m/z 359.2.</p