Biomedical subjects
A Guedenon
Publications and source records attributed to A Guedenon.
[Traditional treatment for Buruli ulcer in Benin].
The purpose of this transversve qualitative study on traditional treatment for Buruli ulcer in Benin was to track the treatment itinerary of patients, the main phases of traditional treatment, cost and efficacy of such treatment, and the knowledge and skills of traditional practitioners. A total of 20 traditional practitioners, 35 patients treated by traditional therapy, and 35 patients treated by surgery were included. Findings showed that both traditional and surgical treatment was sought at a late stage. Reasons determining the type of treatment chosen included religion, access to adequate care facilities, constraints involved in surgical treatment, duration of hospitalization, and fear of scarring. The four main steps in traditional treatment were diagnosis, removal of necrotic tissue, wound care, and exorcism. The cost of traditional treatment was high not only in currency but also by payment in kind (eg., livestock and land). Although it is performed with patient consent, traditional treatment presents a number of risks. Information campaigns are necessary to inform populations about available treatments and the possible risks associated with each modality. Care centers must do more to lessen the constraints involved in surgical treatment both in terms of duration of hospitalization and cosmetic outcome.
[Mycobacterium ulcerans cutaneous infections: Buruli ulcers].
Mycobacterium ulcerans skin infection or Buruli ulcers are common in children in many rural tropical areas. The usual clinical appearance is a deep, rapidly developing chronic ulcer associated with necrosis of subcutaneous fat. Patients are usually seen at an advanced stage. Bacteriologic identification is not always possible because the pathogen, Mycobacterium ulcerans, is an atypical mycobacteria that is difficult to isolate and grows slowly in culture. Medium although of little assistance in tropical regions, the histological features are highly characteristic and can allow diagnosis in areas in which the disease is rare and unsuspected. The pathogenic effects of Mycobacterium ulcerans are due to the production of a necrotizing exotoxin with an immunosuppressive action. Treatment using antituberculosis and antileprosy drugs has been disappointing. Surgery is usually required and causes extensive sequels in many cases, the best technique being an excision/graft procedure. Many epidemiologic characteristics of Buruli ulcers which are andemic in regions with and aquatic ecosystem are still unclear including the mode of infection, transmission and reservoir. Recent outbreaks, particularly in west Africa, may be related to changes in the natural environment.