Researchers at the West African Center for Cell Biology of Infectious Pathogens (WACCBIP) have held a one-day training programme aimed at equipping health workers with the requisite skills to identify and manage Buruli ulcer cases.

The training workshop, funded by the Global Challenge Research Fund under the Medical Research Council of the United Kingdom and supported by WACCBIP, was held at Jacobu in the Amansie Central District of the Ashanti Region and was led by Dr. Lydia Mosi, a lead researcher at WACCBIP.

Dr. Lydia Mosi addresses participants

The workshop brought together over 40 participants, mainly community health workers and volunteers from surrounding towns and villages in the district including Dunkwa-on-Offin, Tankoma, Mile 14, Kofitwikrom, Abuakwa, Kobro, Fiankoma, and Abuntunso.

The St. Peter's District Hospital at Jacobu records a large number of Buruli ulcer cases from surrounding villages. Dr. Mosi, who is also the Head of Department for Biochemistry, Cell and Molecular Biology (BCMB) of the University of Ghana, has been engaging in public education, providing research support and advocating for the eradication of Buruli ulcer in the affected communities since 2010.

Participants follow a lecture at the training workshop

Speaking at the workshop, Dr. Mosi explained that the disease, which was discovered about 150 years ago, is the third most common bacterial infection after TB and Leprosy globally. The disease, she said, is mainly prevalent in West Africa especially in Ghana and Côte d'Ivoire and it affects over 250 people yearly.

“Buruli ulcer is a neglected tropical skin disease caused by environmental pathogen Mycobacterium Ulcerans and how it is transmitted remains uncertain,” she said. “The astonishing part is that the ulcer and sores are painless and the immune system is quickly suppressed because of the toxin called mycolactone. Mycolactone kills the nerve cells in the body making the ulcer painless.”

Participants being trained on how to treat cases of Buruli ulcer

According to Dr. Mosi, not much attention has been given to Buruli ulcer in Ghana, and a lack of proper education on the disease often leads to stigmatisation and the belief that victims practice witchcraft.

She noted that the training was timely and important for early detection of the disease, which would encourage victims from the rural areas in the Amansie Central district to report cases frequently to the hospital.

“This disease is very much underreported mainly because the endemic areas are so rural and far from the nearest health facilities; therefore, clinical removal of the ulcer becomes a choice treatment and many people resort to herbal medicines as treatment. Sadly, disfiguration, disability, and amputation are common outcomes for patients,” she said.

She detailed the current steps being taken towards providing quick diagnosis and treatment of the disease.

“I am happy to share with you the new area of Buruli ulcer research called Metabolomics in Biomarker Discovery and we want to use this to develop quick diagnosis for Buruli ulcer. Our hope is to develop a rapid and immediate diagnostic tool to identify and differentiate Buruli ulcer from other ulcers,” Dr. Mosi said.

Dr. Mosi also donated a motorbike to the District Disease Control Unit to enhance activities of health workers in the surrounding villages, to disseminate information on the disease.

Dr. Lydia Mosi donates a motorbike to the District Disease Control Unit of Amansie Central

Treatment and Sampling collection

Highlighting the importance of sampling at the training, Mr. Charles Quaye, a research fellow with the Noguchi Memorial Institute for Medical Research (NMIMR) said the role of health workers in reaching out to affected patients could not be underestimated in the fight against the disease.

“Health workers need to report cases to health centers after their house-to-house tours for early treatment,” he said.

Mr. Charles Quaye addresses participants

Mr. Akwesi Dwomoh, District Disease Control Unit head takes participants through sample collection

Teaching on sampling collection of the disease,  Mrs. Mabel Sarpong, the Laboratory Manager for the Mosi Laboratory, educated participants on how to take and store samples for tests. “Taking samples are important to confirm that a patient's wound is Buruli ulcer or not, to determine the precise prevalence and incidence of Buruli ulcer in a given area and also to appropriately manage the disease using antimycobacterial therapy,” she said.

The District Health Director for Amansie Central, Mr. Timothy Mensah,
congratulated Dr. Mosi and WACCBIP for their continuous financial support and education in the district. He said the district records lots of Buruli ulcer cases and thus, the training would further equip participants to detect cases early and help to reduce the devastating effect the disease has on its victims.

Parallel Sessions & Peer-Learning

Participants shared their experiences, progress, challenges and lessons learnt at the workshop. Participants were also given the opportunity to ask questions and get feedback from facilitators throughout the workshop.

Participants share ideas

Miss Gloria Koomson, a participant was very happy she attended the workshop. “This is the first time I have attended such a training and it will go a long way to help me identify cases of the disease,” she said. “Most of the topics taught were practical and it has adequately equipped me.”

Mrs. Mabel Sarpong (standing) addresses participants

Participants being trained on taking samples

WACCBIP team at the training workshop

Madam Akua Nsia shares her story

Victim
A victim of Buruli ulcer, Madam Akua Nsia, said the disease has been devouring her left leg for two months and she would not have gone to the hospital if she had not collapsed. The skin around her left leg was swollen with a large, pulpy, reddish, wound covering her ankle.
“I went to the farm one day and got a cut on my leg, the next day, I realized my leg was swollen,” she said. “I thought it was a normal swell, I rubbed and wrapped it with traditional herbs but it turned into a large sore within some few days. There has been an improvement since my daughter brought me to the hospital.”