Buruli ulcer: currents status and options for future prevention.

Buruli ulcer (BU) is a serious skin disease caused by Mycobacterium ulcerans infection. Over the last 10 years, the understanding of the epidemiology, ecology, aetiology and physiopathology of BU has progressed considerably. This paper reviews the current knowledge of BU and the options for future prevention. Currently, the BU is distributed in areas where people are living near swampy areas with stagnant or slow-flowing streams, practicing activities related to water contact with evidence of the presence of M. ulcerans in the environment such as soil, plants, water and aquatic insects. Future options for infection control should be focused on the one hand on the disease diagnosis with development of new laboratory point-of-care tests, and patient treatment by encouraging oral drugs treatment as well as the initiation of traditional plant-based treatments in the context of low- and middle-income countries. On the other hand, the prevention could also be strengthened by wound management as pillar in the BU management and encourage sustainable water, sanitation, and hygiene (WASH) services and practices.