ArticlePLoS neglected tropical diseases2014
Spatio-temporal patterns and landscape-associated risk of Buruli ulcer in Akonolinga, Cameroon.
Article in PLoS neglected tropical diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Transmission models of Mycobacterium ulcerans: A systematic review.PLoS neglected tropical diseases · 2025Pooled it
- Human-induced pressures and environmental factors drive the distribution of neglected tropical disease Buruli ulcer.Communications medicine · 2026Article
- Risk factors for Buruli ulcer disease in Ghana: A matched case-control study in four selected endemic districts of Eastern and Oti Regions.PLoS neglected tropical diseases · 2025Article
- Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone- a prospective cohort study.Infection · 2025Article
- Territorial and gender-linked risk factors for Buruli ulcer in Southern Benin: A case-control study using geographic and behavioral surveying.PLoS neglected tropical diseases · 2025Article
- Current state and future directions of interventions for neglected tropical diseases.Nature human behaviour · 2025Review
- Systematic review: Global host range, case fatality and detection rates ofJournal of clinical tuberculosis and other mycobacterial diseases · 2024Review
- Linking theOne health (Amsterdam, Netherlands) · 2021Review
- Understanding the transmission of Mycobacterium ulcerans: A step towards controlling Buruli ulcer.PLoS neglected tropical diseases · 2021Review
- Stable and Local Reservoirs of Mycobacterium ulcerans Inferred from the Nonrandom Distribution of Bacterial Genotypes, Benin.Emerging infectious diseases · 2020Article
- Domestic animals infected with Mycobacterium ulcerans-Implications for transmission to humans.PLoS neglected tropical diseases · 2018Article
- Climate Change and the Neglected Tropical Diseases.Advances in parasitology · 2018Review
- Buruli Ulcer, a Prototype for Ecosystem-Related Infection, Caused by Mycobacterium ulcerans.Clinical microbiology reviews · 2018Review
- Environmental and Behavioral Drivers of Buruli Ulcer Disease in Selected Communities Along the Densu River Basin of Ghana: A Case-Control Study.The American journal of tropical medicine and hygiene · 2017Article
- Global and local environmental changes as drivers of Buruli ulcer emergence.Emerging microbes & infections · 2017Review
- Landscape and environmental influences on Mycobacterium ulcerans distribution among aquatic sites in Ghana.PloS one · 2017Article
- Evidences of the Low Implication of Mosquitoes in the Transmission ofThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2017Review
- Impact of socioeconomic inequalities on geographic disparities in cancer incidence: comparison of methods for spatial disease mapping.BMC medical research methodology · 2016Article
- Burden and Historical Trend of Buruli Ulcer Prevalence in Selected Communities along the Offin River of Ghana.PLoS neglected tropical diseases · 2016Article
- Neglected Actors in Neglected Tropical Diseases Research: Historical Perspectives on Health Workers and Contemporary Buruli Ulcer Research in Ayos, Cameroon.PLoS neglected tropical diseases · 2016Article
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBuruli ulcer (BU) is an extensively damaging skin infection caused by Mycobacterium ulcerans, whose transmission mode is still unknown. The focal distribution of BU and the absence of interpersonal transmission suggest a major role of environmental factors, which remain unidentified. This study provides the first description of the spatio-temporal variations of BU in an endemic African region, in Akonolinga, Cameroon. We quantify landscape-associated risk of BU, and reveal local patterns of endemicity. METHODOLOGY/PRINCIPAL
findingsFrom January 2002 to May 2012, 787 new BU cases were recorded in 154 villages of the district of Akonolinga. Incidence per village ranged from 0 (n = 59 villages) to 10.4 cases/1000 person.years (py); median incidence was 0.4 cases/1,000 py. Villages neighbouring the Nyong River flood plain near Akonolinga town were identified as the highest risk zone using the SPODT algorithm. We found a decreasing risk with increasing distance to the Nyong and identified 4 time phases with changes in spatial distribution. We classified the villages into 8 groups according to landscape characteristics using principal component analysis and hierarchical clustering. We estimated the incidence ratio (IR) associated with each landscape using a generalised linear model. BU risk was highest in landscapes with abundant wetlands, especially cultivated ones (IR = 15.7, 95% confidence interval [95%CI] = 15.7[4.2-59.2]), and lowest in reference landscape where primary and secondary forest cover was abundant. In intermediate-risk landscapes, risk decreased with agriculture pressure (from IR[95%CI] = 7.9[2.2-28.8] to 2.0[0.6-6.6]). We identified landscapes where endemicity was stable and landscapes where incidence increased with time. CONCLUSION/SIGNIFICANCE: Our study on the largest series of BU cases recorded in a single endemic region illustrates the local evolution of BU and identifies the Nyong River as the major driver of BU incidence. Local differences along the river are explained by wetland abundance and human modification of the environment.
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