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dc.contributor.authorYerramilli, A
dc.contributor.authorTay, EL
dc.contributor.authorStewardson, AJ
dc.contributor.authorKelley, PG
dc.contributor.authorBishop, E
dc.contributor.authorJenkin, GA
dc.contributor.authorStarr, M
dc.contributor.authorTrevillyan, J
dc.contributor.authorHughes, A
dc.contributor.authorFriedman, ND
dc.contributor.authorO'Brien, DP
dc.contributor.authorJohnson, PDR
dc.date.accessioned2020-12-21T02:18:58Z
dc.date.available2020-12-21T02:18:58Z
dc.date.issued2017-08-01
dc.identifierpii: PNTD-D-17-00588
dc.identifier.citationYerramilli, A., Tay, E. L., Stewardson, A. J., Kelley, P. G., Bishop, E., Jenkin, G. A., Starr, M., Trevillyan, J., Hughes, A., Friedman, N. D., O'Brien, D. P. & Johnson, P. D. R. (2017). The location of Australian Buruli ulcer lesions-Implications for unravelling disease transmission. PLOS NEGLECTED TROPICAL DISEASES, 11 (8), https://doi.org/10.1371/journal.pntd.0005800.
dc.identifier.issn1935-2735
dc.identifier.urihttp://hdl.handle.net/11343/256874
dc.description.abstractBACKGROUND: Buruli ulcer (BU), caused by Mycobacterium ulcerans, is increasing in incidence in Victoria, Australia. To improve understanding of disease transmission, we aimed to map the location of BU lesions on the human body. METHODS: Using notification data and clinical records review, we conducted a retrospective observational study of patients diagnosed with BU in Victoria from 1998-2015. We created electronic density maps of lesion locations using spatial analysis software and compared lesion distribution by age, gender, presence of multiple lesions and month of infection. FINDINGS: We examined 579 patients with 649 lesions; 32 (5.5%) patients had multiple lesions. Lesions were predominantly located on lower (70.0%) and upper (27.1%) limbs, and showed a non-random distribution with strong predilection for the ankles, elbows and calves. When stratified by gender, upper limb lesions were more common (OR 1·97, 95% CI 1·38-2·82, p<0·001) while lower limb lesions were less common in men than in women (OR 0·48, 95% CI 0·34-0·68, p<0·001). Patients aged ≥ 65 years (OR 3·13, 95% CI 1·52-6·43, p = 0·001) and those with a lesion on the ankle (OR 2·49, 95% CI 1·14-5·43, p = 0·02) were more likely to have multiple lesions. Most infections (71.3%) were likely acquired in the warmer 6 months of the year. INTERPRETATION: Comparison with published work in Cameroon, Africa, showed similar lesion distribution and suggests the mode of M. ulcerans transmission may be the same across the globe. Our findings also aid clinical diagnosis and provide quantitative background information for further research investigating disease transmission.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.titleThe location of Australian Buruli ulcer lesions-Implications for unravelling disease transmission
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pntd.0005800
melbourne.affiliation.departmentMedicine and Radiology
melbourne.affiliation.departmentPaediatrics (RCH)
melbourne.source.titlePLoS Neglected Tropical Diseases
melbourne.source.volume11
melbourne.source.issue8
dc.rights.licenseCC BY
melbourne.elementsid1229646
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584971
melbourne.contributor.authorO'Brien, Daniel
melbourne.contributor.authorJohnson, Paul
melbourne.contributor.authorStarr, Michael
dc.identifier.eissn1935-2735
melbourne.accessrightsOpen Access


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