Pathogenesis and Management of M. Ulcerans Disease, Buruli Ulcer (Buruli_Path)
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|ClinicalTrials.gov Identifier: NCT02153034|
Recruitment Status : Unknown
Verified March 2017 by Dr Richard Phillips, Kwame Nkrumah University of Science and Technology.
Recruitment status was: Active, not recruiting
First Posted : June 2, 2014
Last Update Posted : March 23, 2017
Buruli ulcer is a neglected tropical disease caused by infection with Mycobacterium ulcerans (Mu) in rural parts of West Africa. It causes large skin ulcers mainly in children aged 5 to 15 years. Access to treatment is limited and many cases present late. There have been major advances in understanding the mechanism of disease together with improved diagnosis and management. The aim of the proposed studies is to identify markers predictive of a rapid response to antibiotic treatment and to investigate the pathogenesis of paradoxical reactions and oedematous lesions in Mu disease.
Infection with Mu results in a nodule under the skin which enlarges and breaks down to form an ulcer. This is because Mu produces a toxin that spreads outwards and damages subcutaneous tissue. In recent years it has been found that antibiotic treatment for 8 weeks with daily tablets and intramuscular injections heals ulcers. This is unpleasant and it would be better if the treatment could be shortened. Our previous studies suggest this may be possible. Therefore a wide range of tests will be investigated in order to identify markers for people in whom the infection is at an early stage with low numbers of Mu bacteria and low levels of toxin in the skin. During antibiotic treatment the rate of healing will be measured to find out which markers are the most reliable.
In some patients new areas of inflammation develop despite treatment and this is called a paradoxical reaction. The immune response to Mu will be investigated serially during antibiotic treatment to investigate the cause of paradoxical reactions.
About 15% of patients have oedematous disease, the most severe form of Buruli ulcer. We will study the amount of Mu toxin produced by the strain of Mu cultured from patients with this form of the disease.
- Buruli ulcer patients that heal rapidly/slowly or develop paradoxical reactions with treatment will have associated predictive viability or serum biomarkers.
- Buruli ulcer patients with oedematous disease are associated with larger amounts of mycolactone and viable organisms
|Condition or disease|
|Buruli Ulcer Mycobacterium Ulcerans Disease|
Show Detailed Description
|Study Type :||Observational|
|Actual Enrollment :||400 participants|
|Official Title:||A Study of the Pathogenesis and Management of M. Ulcerans Disease, Buruli Ulcer|
|Study Start Date :||May 2013|
|Actual Primary Completion Date :||December 15, 2016|
|Estimated Study Completion Date :||January 2018|
Buruli ulcer patients, no intervention
Buruli ulcer patients administered standard standard care by the attending physician
Healthy contacts, no intervention
Healthy volunteers who will be contacts of patients recruited or non-endemic controls. No intervention will be administered
- Measurement of serum/plasma proteins in diseased and healthy subjects [ Time Frame: Assessed for diseased participants at baseline, 8, 12, 16 weeks and only at baseline for healthy subjects ]
- Viable M. ulcerans and bacterial load measurement in tissue of diseased subjects [ Time Frame: Assessed at baseline, 4, 8, 12, 16 only if lesions are not healed ]
- Mycolactone measurement in tissue of diseased subjects [ Time Frame: Assessed at baseline, 4, 8, 12, 16 only if lesions are not healed ]
- Rate of healing and time to healing in diseased subjects [ Time Frame: The primary outcome measure will be assessed for each participant at the time of healing which will vary for participants ]
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02153034
|Tepa Government Hospital|
|Tepa, Ahafo Ano North district, Ghana|
|Agogo Presbyterian Hospital|
|Agogo, Asante Akim North District, Ghana|
|Nkawie Government Hospital|
|Nkawie, Atwima Nwabiangya district, Ghana|
|Principal Investigator:||Richard O Phillips, FWACP,FGCP||Kwame Nkrumah University of Science and Technology|