Treatment Outcome of Patients with Buruli Ulcer Disease in Togo
Following introduction of antimycobacterial treatment of Buruli ulcer disease (BUD), several clinical studies evaluated treatment outcomes of BUD patients, in particular healing times, secondary lesions and functional limitations. Whereas recurrences were rarely observed, paradoxical reactions and f...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2015-10, Vol.9 (10), p.e0004170-e0004170 |
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| creator | Beissner, Marcus Arens, Nathalie Wiedemann, Franz Piten, Ebekalisaï Kobara, Basile Bauer, Malkin Herbinger, Karl-Heinz Badziklou, Kossi Banla Kere, Abiba Löscher, Thomas Nitschke, Jörg Bretzel, Gisela |
| description | Following introduction of antimycobacterial treatment of Buruli ulcer disease (BUD), several clinical studies evaluated treatment outcomes of BUD patients, in particular healing times, secondary lesions and functional limitations. Whereas recurrences were rarely observed, paradoxical reactions and functional limitations frequently occurred. Although systematic BUD control in Togo was established as early as 2007, treatment outcome has not been reviewed to date. Therefore, a pilot project on post-treatment follow-up of BUD patients in Togo aimed to evaluate treatment outcomes and to provide recommendations for optimization of treatment success.
Out of 199 laboratory confirmed BUD patients, 129 could be enrolled in the study. The lesions of 109 patients (84.5%) were completely healed without any complications, 5 patients (3.9%) had secondary lesions and 15 patients (11.6%) had functional limitations. Edema, category III ulcers >15 cm, healing times >180 days and a limitation of movement at time of discharge constituted the main risk factors significantly associated with BUD related functional limitations (P180 days and limitation of movement at discharge constituted the main risk factors for functional limitations in Togolese BUD patients. Standardized treatment plans, patient assessment and follow-up, as well as improved management of medical records are recommended to allow for intensified monitoring of disease progression and healing process, to facilitate implementation of therapeutic measures and to optimize treatment success. |
| doi_str_mv | 10.1371/journal.pntd.0004170 |
| format | Article |
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Out of 199 laboratory confirmed BUD patients, 129 could be enrolled in the study. The lesions of 109 patients (84.5%) were completely healed without any complications, 5 patients (3.9%) had secondary lesions and 15 patients (11.6%) had functional limitations. Edema, category III ulcers >15 cm, healing times >180 days and a limitation of movement at time of discharge constituted the main risk factors significantly associated with BUD related functional limitations (P<0.01). Review of all BUD related documentation revealed major shortcomings, in particular concerning medical records on adjuvant surgical and physiotherapeutic treatment.
This study presents the first systematic analysis of treatment outcome of BUD patients from Togo. Median times to healing and the absence of recurrences were in line with findings reported by other investigators. The percentage of functional limitations of 11.6% was lower than in other studies, and edema, category III ulcers, healing time >180 days and limitation of movement at discharge constituted the main risk factors for functional limitations in Togolese BUD patients. Standardized treatment plans, patient assessment and follow-up, as well as improved management of medical records are recommended to allow for intensified monitoring of disease progression and healing process, to facilitate implementation of therapeutic measures and to optimize treatment success.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0004170</identifier><identifier>PMID: 26474069</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Aged ; Anti-Bacterial Agents - therapeutic use ; Buruli ulcer ; Buruli Ulcer - drug therapy ; Child ; Child, Preschool ; Clinical outcomes ; Development and progression ; Disease ; Documentation ; Edema ; Female ; Follow-Up Studies ; Funding ; Genetic aspects ; Humans ; Laboratories ; Male ; Medical records ; Middle Aged ; Patients ; Physical therapy ; Pilot Projects ; Recurrence ; Risk factors ; Skin diseases ; Streptomycin ; Studies ; Togo ; Treatment Outcome ; Wound Healing ; Young Adult</subject><ispartof>PLoS neglected tropical diseases, 2015-10, Vol.9 (10), p.e0004170-e0004170</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Beissner et al 2015 Beissner et al</rights><rights>2015 Public Library of Science. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Beissner M, Arens N, Wiedemann F, Piten E, Kobara B, Bauer M, et al. (2015) Treatment Outcome of Patients with Buruli Ulcer Disease in Togo. PLoS Negl Trop Dis 9(10): e0004170. doi:10.1371/journal.pntd.0004170</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c596t-1eb0384bf770381686051156bbf175b8a3a87526738b459df3d23c8131e060be3</citedby><cites>FETCH-LOGICAL-c596t-1eb0384bf770381686051156bbf175b8a3a87526738b459df3d23c8131e060be3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608783/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4608783/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26474069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Johnson, Christian</contributor><creatorcontrib>Beissner, Marcus</creatorcontrib><creatorcontrib>Arens, Nathalie</creatorcontrib><creatorcontrib>Wiedemann, Franz</creatorcontrib><creatorcontrib>Piten, Ebekalisaï</creatorcontrib><creatorcontrib>Kobara, Basile</creatorcontrib><creatorcontrib>Bauer, Malkin</creatorcontrib><creatorcontrib>Herbinger, Karl-Heinz</creatorcontrib><creatorcontrib>Badziklou, Kossi</creatorcontrib><creatorcontrib>Banla Kere, Abiba</creatorcontrib><creatorcontrib>Löscher, Thomas</creatorcontrib><creatorcontrib>Nitschke, Jörg</creatorcontrib><creatorcontrib>Bretzel, Gisela</creatorcontrib><title>Treatment Outcome of Patients with Buruli Ulcer Disease in Togo</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Following introduction of antimycobacterial treatment of Buruli ulcer disease (BUD), several clinical studies evaluated treatment outcomes of BUD patients, in particular healing times, secondary lesions and functional limitations. Whereas recurrences were rarely observed, paradoxical reactions and functional limitations frequently occurred. Although systematic BUD control in Togo was established as early as 2007, treatment outcome has not been reviewed to date. Therefore, a pilot project on post-treatment follow-up of BUD patients in Togo aimed to evaluate treatment outcomes and to provide recommendations for optimization of treatment success.
Out of 199 laboratory confirmed BUD patients, 129 could be enrolled in the study. The lesions of 109 patients (84.5%) were completely healed without any complications, 5 patients (3.9%) had secondary lesions and 15 patients (11.6%) had functional limitations. Edema, category III ulcers >15 cm, healing times >180 days and a limitation of movement at time of discharge constituted the main risk factors significantly associated with BUD related functional limitations (P<0.01). Review of all BUD related documentation revealed major shortcomings, in particular concerning medical records on adjuvant surgical and physiotherapeutic treatment.
This study presents the first systematic analysis of treatment outcome of BUD patients from Togo. Median times to healing and the absence of recurrences were in line with findings reported by other investigators. The percentage of functional limitations of 11.6% was lower than in other studies, and edema, category III ulcers, healing time >180 days and limitation of movement at discharge constituted the main risk factors for functional limitations in Togolese BUD patients. Standardized treatment plans, patient assessment and follow-up, as well as improved management of medical records are recommended to allow for intensified monitoring of disease progression and healing process, to facilitate implementation of therapeutic measures and to optimize treatment success.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Buruli ulcer</subject><subject>Buruli Ulcer - drug therapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical outcomes</subject><subject>Development and progression</subject><subject>Disease</subject><subject>Documentation</subject><subject>Edema</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Funding</subject><subject>Genetic aspects</subject><subject>Humans</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical records</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Physical therapy</subject><subject>Pilot Projects</subject><subject>Recurrence</subject><subject>Risk factors</subject><subject>Skin diseases</subject><subject>Streptomycin</subject><subject>Studies</subject><subject>Togo</subject><subject>Treatment Outcome</subject><subject>Wound Healing</subject><subject>Young Adult</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>DOA</sourceid><recordid>eNptkl1rFDEUhgdRbK3-A9EBQbzZNZl87o1S61ehUC-21yGTOdnNkpmsSUbx35txp2UXJBcJJ895zwdvVb3EaImJwO93YYyD9sv9kLslQohigR5V53hF2KIRhD0-ep9Vz1LaIcRWTOKn1VnDqaCIr86rj-sIOvcw5Pp2zCb0UAdb_9DZlVCqf7u8rT-NcfSuvvMGYv3ZJdAJajfU67AJz6snVvsEL-b7orr7-mV99X1xc_vt-uryZmHYiucFhhYRSVsrRLkxlxwxjBlvW4sFa6UmWgrWcEFkS9mqs6RriJGYYEActUAuqtcH3b0PSc2zJ4UFIZwywVEhrg9EF_RO7aPrdfyjgnbqXyDEjdIxO-NBNRozgyW1nWmpJaK11iLKwSDJRaOnah_mamPbQ2fKLqL2J6KnP4Pbqk34pShHUkhSBN7NAjH8HCFl1btkwHs9QBinvhvacIQkK-ibA7rRpTU32FAUzYSrS0oowwwTWqjlf6hyOuidCQNYV-InCW-PEragfd6m4MfswpBOQXoATQwpRbAPY2KkJqfdb1tNTlOz00raq-MVPSTdW4v8Bfm9zjc</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Beissner, Marcus</creator><creator>Arens, Nathalie</creator><creator>Wiedemann, Franz</creator><creator>Piten, Ebekalisaï</creator><creator>Kobara, Basile</creator><creator>Bauer, Malkin</creator><creator>Herbinger, Karl-Heinz</creator><creator>Badziklou, Kossi</creator><creator>Banla Kere, Abiba</creator><creator>Löscher, Thomas</creator><creator>Nitschke, Jörg</creator><creator>Bretzel, Gisela</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20151001</creationdate><title>Treatment Outcome of Patients with Buruli Ulcer Disease in Togo</title><author>Beissner, Marcus ; Arens, Nathalie ; Wiedemann, Franz ; Piten, Ebekalisaï ; Kobara, Basile ; Bauer, Malkin ; Herbinger, Karl-Heinz ; Badziklou, Kossi ; Banla Kere, Abiba ; Löscher, Thomas ; Nitschke, Jörg ; Bretzel, Gisela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c596t-1eb0384bf770381686051156bbf175b8a3a87526738b459df3d23c8131e060be3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Buruli ulcer</topic><topic>Buruli Ulcer - drug therapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical outcomes</topic><topic>Development and progression</topic><topic>Disease</topic><topic>Documentation</topic><topic>Edema</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Funding</topic><topic>Genetic aspects</topic><topic>Humans</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical records</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Physical therapy</topic><topic>Pilot Projects</topic><topic>Recurrence</topic><topic>Risk factors</topic><topic>Skin diseases</topic><topic>Streptomycin</topic><topic>Studies</topic><topic>Togo</topic><topic>Treatment Outcome</topic><topic>Wound Healing</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Beissner, Marcus</creatorcontrib><creatorcontrib>Arens, Nathalie</creatorcontrib><creatorcontrib>Wiedemann, Franz</creatorcontrib><creatorcontrib>Piten, Ebekalisaï</creatorcontrib><creatorcontrib>Kobara, Basile</creatorcontrib><creatorcontrib>Bauer, Malkin</creatorcontrib><creatorcontrib>Herbinger, Karl-Heinz</creatorcontrib><creatorcontrib>Badziklou, Kossi</creatorcontrib><creatorcontrib>Banla Kere, Abiba</creatorcontrib><creatorcontrib>Löscher, Thomas</creatorcontrib><creatorcontrib>Nitschke, Jörg</creatorcontrib><creatorcontrib>Bretzel, Gisela</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Beissner, Marcus</au><au>Arens, Nathalie</au><au>Wiedemann, Franz</au><au>Piten, Ebekalisaï</au><au>Kobara, Basile</au><au>Bauer, Malkin</au><au>Herbinger, Karl-Heinz</au><au>Badziklou, Kossi</au><au>Banla Kere, Abiba</au><au>Löscher, Thomas</au><au>Nitschke, Jörg</au><au>Bretzel, Gisela</au><au>Johnson, Christian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment Outcome of Patients with Buruli Ulcer Disease in Togo</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>9</volume><issue>10</issue><spage>e0004170</spage><epage>e0004170</epage><pages>e0004170-e0004170</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Following introduction of antimycobacterial treatment of Buruli ulcer disease (BUD), several clinical studies evaluated treatment outcomes of BUD patients, in particular healing times, secondary lesions and functional limitations. Whereas recurrences were rarely observed, paradoxical reactions and functional limitations frequently occurred. Although systematic BUD control in Togo was established as early as 2007, treatment outcome has not been reviewed to date. Therefore, a pilot project on post-treatment follow-up of BUD patients in Togo aimed to evaluate treatment outcomes and to provide recommendations for optimization of treatment success.
Out of 199 laboratory confirmed BUD patients, 129 could be enrolled in the study. The lesions of 109 patients (84.5%) were completely healed without any complications, 5 patients (3.9%) had secondary lesions and 15 patients (11.6%) had functional limitations. Edema, category III ulcers >15 cm, healing times >180 days and a limitation of movement at time of discharge constituted the main risk factors significantly associated with BUD related functional limitations (P<0.01). Review of all BUD related documentation revealed major shortcomings, in particular concerning medical records on adjuvant surgical and physiotherapeutic treatment.
This study presents the first systematic analysis of treatment outcome of BUD patients from Togo. Median times to healing and the absence of recurrences were in line with findings reported by other investigators. The percentage of functional limitations of 11.6% was lower than in other studies, and edema, category III ulcers, healing time >180 days and limitation of movement at discharge constituted the main risk factors for functional limitations in Togolese BUD patients. Standardized treatment plans, patient assessment and follow-up, as well as improved management of medical records are recommended to allow for intensified monitoring of disease progression and healing process, to facilitate implementation of therapeutic measures and to optimize treatment success.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26474069</pmid><doi>10.1371/journal.pntd.0004170</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Anti-Bacterial Agents - therapeutic use Buruli ulcer Buruli Ulcer - drug therapy Child Child, Preschool Clinical outcomes Development and progression Disease Documentation Edema Female Follow-Up Studies Funding Genetic aspects Humans Laboratories Male Medical records Middle Aged Patients Physical therapy Pilot Projects Recurrence Risk factors Skin diseases Streptomycin Studies Togo Treatment Outcome Wound Healing Young Adult |
| title | Treatment Outcome of Patients with Buruli Ulcer Disease in Togo |
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