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[ABIDJAN] West African researchers hope to identify how Buruli ulcer bacteria (Mycobacterium ulcerans) are transmitted to humans, through the development of an international and multidisciplinary research programme.

A handbook of procedures for fieldwork was drawn up last month (27 December). The programme will also aim to identify better prevention strategies for the disabling disease, which causes patients to develop unsightly open sores on their skin, and can lead to amputation and deformities, leading to a loss of work, agricultural production and education.

The programme, agreed at a workshop of Buruli ulcer experts in Ghana last year (7–9 November), will link agriculture, the environment and health.

During the workshop, experts shared their experiences and discussed what remains unknown about the disease — in particular the mystery of how M. ulcerans is transmitted from the environment to human beings.

Recent information suggests that M. ulcerans does not live freely in the environment, as previously thought, but is likely to occupy a specific niche within aquatic environments (for example in small aquatic animals) from where it is transmitted to humans by an unknown mechanism.

Kouadio Daniel, head doctor of the N'douci health center in Côte d'Ivoire, told SciDev.Net that research on transmission is essential for countering the disease. "We cannot develop an efficient system of prevention if we don't know the exact transmission mechanism."

Other problems include the treatment for the disease, which takes six months to a year and is extremely expensive, said Rousseau Djouaka, a researcher at the Benin branch of the International Institute for Tropical Agriculture (IITA). "Even with government support, we need 25 per cent of the patient's family income to treat the disease — not to mention the indirect costs."

Research into areas such as agricultural practices, soil data and water systems will be carried out in Benin, Cameroon, Côte d'Ivoire and Ghana. Djouaka said that the research approach is based on the agro-eco-health alliance, which was launched at IITA Benin in May 2010. "We [will] take into account all the experts who work in the environment where the Buruli ulcer vector is present. That is, agronomists, hydrochemists, biochemists and so on."

He said that the team will need 3 to 5 years to detect the way of transmission of the disease vector to the human being.

But he warned that a lack of funding may compromise the programme. "Buruli ulcer is listed as a neglected disease, as it does not mobilise funders. To carry on the research programme we will need US$1.3–1.5 million a year".