Volume 24, Number 11—November 2018
Synopsis
Epidemiology of Buruli Ulcer Infections, Victoria, Australia, 2011–2016
Michael J. Loftus, Ee Laine Tay, Maria Globan, Caroline J. Lavender, Simon R. Crouch, Paul D.R. Johnson1
, and Janet A.M. Fyfe1
, and Janet A.M. Fyfe1
Table 1
Clinical site and severity, delays to first healthcare visit and diagnosis, and management strategies for Buruli ulcer case-patients, by age and region of exposure, Victoria, Australia, 2011–2016*
| Variable |
Total no. (%) |
Age group, y | Exposure, definite at area level, n = 565 | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| <15 |
15–60 |
>60 |
p value† |
BP |
MP |
Other |
p value† |
|||
| Total |
600 |
72 (12.0) |
285 (47.5) |
243 (40.5) |
235 (39.2) |
247 (41.2) |
83 (13.8) |
|||
| Lesion site, total no. | 585 | 71 | 278 | 236 | 0.381‡ | 228 | 240 | 82 | 0.003‡ | |
| Lower limb | 424 (72.5) | 52 (70.3) | 210 (75.5) | 162 (68.6) | 154 (67.5) | 182 (75.8) | 58 (70.7) | |||
| Below knee | 306 (52.3) | 31 (41.9) | 149 (53.6) | 126 (53.4) | 109 (47.8) | 129 (53.8) | 45 (54.9) | |||
| Knee or above | 86 (14.7) | 16 (21.6) | 48 (17.3) | 22 (9.3) | 33 (14.5) | 39 (16.3) | 10 (12.2) | |||
| Unspecified | 32 (5.5) | 5 (6.8) | 16 (5.8) | 14 (5.9) | 12 (5.3) | 14 (5.8) | 3 (3.7) | |||
| Upper limb | 140 (23.9) | 17 (23) | 61 (21.9) | 62 (26.3) | 71 (31.1) | 45 (18.8) | 19 (23.2) | |||
| Other sites | 12 (2.1) | 1 (1.4) | 6 (2.2) | 5 (2.1) | 2 (0.9) | 9 (3.8) | 1 (1.2) | |||
| Head/neck | 5 (0.9) | 1 (1.4) | 2 (0.7) | 2 (0.8) | 1 (0.4) | 4 (1.7) | 0 (0.0) | |||
| Torso | 4 (0.7) | 0 (0) | 2 (0.7) | 2 (0.8) | 1 (0.4) | 2 (0.8) | 1 (1.2) | |||
| Buttock/perineum | 3 (0.5) | 0 (0) | 2 (0.7) | 1 (0.4) | 0 | 3 (1.3) | 0 | |||
| >1 site |
9 (1.5) |
1 (1.4) |
1 (0.4) |
7 (3.0) |
1 (0.4) |
4 (1.7) |
4 (4.9) |
|||
| WHO category, total no. | 523 | 64 | 244 | 215 | 0.041 | 198 | 221 | 69 | 0.219 | |
| I | 415 (79.3) | 53 (82.8) | 204 (83.6) | 158 (73.5) | 166 (83.8) | 171 (77.4) | 52 (75.4) | |||
| II | 71 (13.6) | 7 (10.9) | 30 (12.3) | 34 (15.8) | 23 (11.6) | 34 (15.4) | 9 (13.0) | |||
| III |
37 (7.1) |
4 (6.3) |
10 (4.1) |
23 (10.7) |
9 (4.5) |
16 (7.2) |
8 (11.6) |
|||
| Time to healthcare visit | 0.0146 | 0.2770 | ||||||||
| Median (IQR), d |
28
(14–60) |
21
(14–36) |
30
(14–60) |
21
(14–49) |
28
(14–42) |
30
(14–60) |
30
(14–60) |
|||
| Time to diagnosis | 0.1536 | 0.0001 | ||||||||
| Median (IQR), d |
63
(35–109) |
63
(39–122) |
65
(37–114) |
54
(31–103) |
46
(27–83) |
70
(37–119) |
82
(21–127) |
|||
| Treatment, total no. | 517 | 65 | 227 | 214 | 0.606 | 205 | 210 | 69 | 0.281 | |
| Antimicrobial drugs only | 328 (63.4) | 41 (63.1) | 145 (63.9) | 142 (66.4) | 137 (66.8) | 135 (64.3) | 37 (53.6) | |||
| Surgery only | 27 (5.2) | 2 (3.1) | 16 (7) | 9 (4.2) | 12 (5.9) | 9 (4.3) | 5 (7.2) | |||
| Antimicrobial drugs
and surgery |
162 (31.3) |
22 (33.8) |
77 (33.9) |
63 (29.4) |
56 (27.3) |
66 (31.4) |
27 (39.1) |
|||
| Surgery, total no. | 165 | 19 | 81 | 65 | 0.621 | 59 | 66 | 26 | 0.671 | |
| Debridement | 54 (32.7) | 6 (31.6) | 29 (35.8) | 19 (29.2) | 20 (33.9) | 23 (34.8) | 5 (19.2) | |||
| Narrow excision | 53 (32.1) | 8 (42.1) | 26 (32.1) | 19 (29.2) | 19 (32.2) | 20 (30.3) | 10 (38.5) | |||
| Wide excision | 58 (35.2) | 5 (26.3) | 26 (32.1) | 27 (41.5) | 20 (33.9) | 23 (34.8) | 11 (42.3) | |||
*Values are no. (%) patients except as indicated. BP, Bellarine Peninsula; IQR, interquartile range; MP, Mornington Peninsula; WHO, World Health Organization.
†p value provides comparisons across all categories.
‡p value provides comparison between lower limb, upper limb, all other sites, and patient age or exposure location.
1Joint senior authors.
Page created: October 16, 2018
Page updated: October 16, 2018
Page reviewed: October 16, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.