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Mycobacterium ulcerans infection: factors influencing diagnostic delay
Author(s) -
Quek Tricia Y J,
Henry Margaret J,
Pasco Julie A,
O’Brien Daniel P,
Johnson Paul D R,
Hughes Andrew,
Cheng Allen C,
ReddenHoare Jane,
Athan Eugene
Publication year - 2007
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2007.tb01416.x
Subject(s) - mycobacterium ulcerans , buruli ulcer , interquartile range , medicine , epidemiology , outbreak , pediatrics , disease , pathology
Objective: To document the epidemiology, clinical characteristics and diagnosis of an outbreak of Mycobacterium ulcerans infection (Bairnsdale or Buruli ulcer [BU]) during the period 1998–2006, and compare delays in diagnosis between residents of endemic and non‐endemic regions. Design and setting: Retrospective case study of patients identified through infectious disease physicians on the Bellarine Peninsula and the Victorian Department of Human Services notifiable diseases database. Main outcome measures: Description of events leading to diagnosis of BU. Results: Eighty‐five BU patients recalled their experience. Fifty‐three patients were older than 60 years, and 61 permanently resided on the Bellarine Peninsula. The onset of symptoms occurred most frequently in mid winter. Twenty‐eight patients had lesions on the arm and 51 on the leg. The median time between onset of symptoms and first medical contact was shorter for those living in the endemic area (3.0 weeks; interquartile range [IQR], 1.0–5.0 weeks) compared with non‐endemic areas (5.3 weeks; IQR, 2.0–9.5 weeks) ( P = 0.05). Patients who resided in the endemic area had a shorter median time from their first medical appointment to diagnosis (1.0 week; IQR, 0.0–3.9 weeks) than those who resided in non‐endemic areas (5.0 weeks; IQR, 1.3–8.0 weeks) ( P = 0.001). Conclusion: Delay in presentation and time to diagnosis of BU are longer in non‐endemic than endemic areas. Measures should be taken to raise awareness of the disease in non‐endemic areas.