ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Diagnostic Accuracy of Clinical and Microbiological Signs in Patients With Skin Lesions Resembling Buruli Ulcer in an Endemic Region.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Individual and clinical variables associated with the risk of Buruli ulcer acquisition: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2020Pooled it
- Pooled it
- Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone- a prospective cohort study.Infection · 2025Article
- Volatile organic compound detection of Buruli ulcer disease: Headspace analysis of Mycobacterium ulcerans and used gauzes of Buruli-compatible ulcers.PLoS neglected tropical diseases · 2024Article
- Systematic review: Global host range, case fatality and detection rates ofJournal of clinical tuberculosis and other mycobacterial diseases · 2024Review
- Evaluation of an electricity-independent method for IS2404 Loop-mediated isothermal amplification (LAMP) diagnosis of Buruli ulcer in resource-limited settings.PLoS neglected tropical diseases · 2024Article
- Review
- Deep learning for AI-based diagnosis of skin-related neglected tropical diseases: A pilot study.PLoS neglected tropical diseases · 2023Article
- Deep learning for AI-based diagnosis of skin-related neglected tropical diseases: a pilot study.medRxiv : the preprint server for health sciences · 2023Article
- Methods and Approaches for Buruli Ulcer Surveillance in Africa: Lessons Learnt and Future Directions.Methods in molecular biology (Clifton, N.J.) · 2022Review
- Chronic wounds in Sierra Leone: Searching for Buruli ulcer, a NTD caused by Mycobacterium ulcerans, at Masanga Hospital.PLoS neglected tropical diseases · 2021Article
- Genome-wide association study of Buruli ulcer in rural Benin highlights role of two LncRNAs and the autophagy pathway.Communications biology · 2020Article
- Global Epidemiology of Buruli Ulcer, 2010-2017, and Analysis of 2014 WHO Programmatic Targets.Emerging infectious diseases · 2019Article
- Improving clinical and epidemiological predictors of Buruli ulcer.PLoS neglected tropical diseases · 2018Article
- Laboratory confirmation of Buruli ulcer cases in Ghana, 2008-2016.PLoS neglected tropical diseases · 2018Article
- Microdeletion on chromosome 8p23.1 in a familial form of severe Buruli ulcer.PLoS neglected tropical diseases · 2018Article
- Buruli Ulcer: a Review of the Current Knowledge.Current tropical medicine reports · 2018Review
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Authors and funding
12 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The diagnosis of the neglected tropical skin and soft tissue disease Buruli ulcer (BU) is made on clinical and epidemiological grounds, after which treatment with BU-specific antibiotics is initiated empirically. Given the current decline in BU incidence, clinical expertise in the recognition of BU is likely to wane and laboratory confirmation of BU becomes increasingly important. We therefore aimed to determine the diagnostic accuracy of clinical signs and microbiological tests in patients presenting with lesions clinically compatible with BU. Methods: A total of 227 consecutive patients were recruited in southern Benin and evaluated by clinical diagnosis, direct smear examination (DSE), polymerase chain reaction (PCR), culture, and histopathology. In the absence of a gold standard, the final diagnosis in each patient was made using an expert panel approach. We estimated the accuracy of each test in comparison to the final diagnosis and evaluated the performance of 3 diagnostic algorithms. Results: Among the 205 patients with complete data, the attending clinicians recognized BU with a sensitivity of 92% (95% confidence interval [CI], 85%-96%), which was higher than the sensitivity of any of the laboratory tests. However, 14% (95% CI, 7%-24%) of patients not suspected to have BU at diagnosis were classified as BU by the expert panel. The specificities of all diagnostics were high (≥91%). All diagnostic algorithms had similar performances. Conclusions: A broader clinical suspicion should be recommended to reduce missed BU diagnoses. Taking into consideration diagnostic accuracy, time to results, cost-effectiveness, and clinical generalizability, a stepwise diagnostic approach reserving PCR to DSE-negative patients performed best.
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