Despite great advances in the diagnosis and treatment of Buruli ulcer, it is one of the least studied major neglected tropical diseases. In Africa, major constraints in the management of Buruli ulcer relate to diagnosis and treatment, and accessibility, feasibility, and delivery of services. In this paper, key areas for clinical, diagnostic, and operational research on this disease in Africa are outlined and a research agenda that aims to advance the management of Buruli ulcer in Africa is proposed.

A model of care is needed to increase early case detection, to diagnose the disease accurately, to simplify and improve treatment, to reduce side-effects of treatment, to deal with populations with HIV and tuberculosis appropriately, to decentralise care, and to scale up coverage in populations at risk. This approach will require commitment and support to strategically implement research by national Buruli ulcer programmes and international technical and donor organisations, combined with adaptations in programme design and advocacy. A critical next step is to build consensus for a research agenda with WHO and relevant groups experienced in Buruli ulcer care or related diseases, and we call on on them to help to turn this agenda into reality.

Authors

Daniel P O’Brien, Eric Comte, Micaela Serafini, Geneviève Ehounou, Annick Antierens, Hubert Vuagnat, Vanessa Christinet, Mitima D Hamani, Philipp du Cros