Invited Commentary

Invited Commentary Eur J Plast Surg (2000) 23:329 © Springer-Verlag 2000 The publication of this modest contribution on the ravag- The authors of the paper are right to emphasize that es of Buruli ulcer in Ghana by Doctor Agbenorku et al. the optimum time to deal with this disease is in the will, despite the absence of linked before and after illus- early stages, when it may present as a circumscribed trations (not always easy to obtain in the local circum- skin nodule, but experience in the lower coastal area stances), serve as a timely indicator to non-tropical peo- around Accra would indicate that the often still avail- ples of the seriousness of this crippling disease, which af- able, simpler, low-cost option of consulting the village flicts low-economy countries all over the tropical world. sage or medicine man or woman often hinders early in- The condition involves particularly children as young formed diagnosis and treatment. Serious efforts are be- as 15 months in its active phase, although it can eventu- ing made to educate and assist parents at grassroots ally burn itself out in survivors. This appallingly inca- level, but equally important is the need to make avail- pacitating disease process has so far proved totally unaf- able free, effective, early treatment to peoples burdened fected by therapeutic means, and little is known about by the I.M.F. restrictions tied to loans made to their how it has spread; direct inoculation is a possible cause countries. of infection. The fact that it is more prevalent in swampy areas might suggest that a vector such as a snail is in- volved, but much coordinated research is needed to elu- J.C. Mustardé cidate these problems. Longhill Avenue 90, Ayr KA7 4DF, UK European Journal of Plastic Surgery Springer Journals

Invited Commentary

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Copyright © 2000 by Springer-Verlag Berlin Heidelberg
Medicine & Public Health; Plastic Surgery
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