01881nas a2200193   4500000000100000008004100001653003900042653001700081653001300098653002200111653002500133653001000158100001300168700002000181245011300201250000800314300000700322520135800329       2018                            d10aNeglected tropical diseases (NTDs)10aBuruli ulcer10aLand use10aLand cover change10aSpatial distribution10aGhana1 aOppong J1 aRuckthongsook W00aThe impact of land use and land cover change on the spatial distribution of Buruli ulcer in southwest Ghana.  a1st  a213 a<p>BU is considered a non-communicable disease (Portaels et al. 2008) mostly attributed to human activity associated with water bodies, man-made environmental change, and degradation including excessive flooding during heavy rainfall, the damming of streams and rivers to create artificial lakes and wetlands, wetland modification, and deforestation practices that increase flooding (Merritt et al. 2005, Bratschi et al. 2013). Moreover, recent cross-sectional studies indicate that some environmental factors including stagnant water (Duker et al. 2006b, Pouillot et al. 2007, Brou et al. 2008,Wagner et al. 2008), wood/forest land cover (Brou et al. 2008), land elevation (Walsh et al. 2008, Wagner et al. 2008), seasonal variation (Duker et al. 2006b, Portaels et al. 2009), agriculture (Pouillot et al. 2007, Brou et al. 2008), and economic factors (Duker et al. 2006a) may be associated with BU. However, pinpointing the exact environmental factor in exposure has been a difficult challenge, because most patients are unable to recall where or when they possibly were exposed to M. ulcerans (van der Werf et al. 2005) since most BU infections are detected after a long period of time. Furthermore, due to severe underreporting, missed BU cases may indicate other risk factors or associations of BU in humans that have not yet been discovered.</p>