Buruli Ulcer: Environmental Determinants Assessment, A field Study- Akonolinga, Cameroon

Buruli Ulcer (BU), one of the Neglected Tropical Diseases (NTDs), is the third most common Mycobacterium spp. related disease after tuberculosis (TB) and leprosy. BU is caused by M. ulcerans, which is phylogenetically related to the fish pathogen M. marinum. Farming and fishing along the Nyong River, near Akonolinga, Cameroon, is thought to expose residents to water and insects that make residents susceptible to infection with M. ulcerans. The reservoir for BU is still a quandary and WHO guidelines recommend continued study on its mode of transmission. This study was aimed at elucidating the environmental origin and potential reservoirs of M. ulcerans along the Nyong River basin, the most endemic region of Cameroon. Environmental samples were taken along the Nyong river basin in Ndibi, Abong Mbong, and Ayos, as well as fishing grounds in Akonolinga during the month of July in 2013. Swab samples were taken from insects, fish, cow’s blood and dung, domestic dogs, frogs, porcupine, muddy water, plants, algae and other environmental sources. DNA extraction was performed together with RT-PCR using the insertion sequence IS2404 for each of the samples. All PCR results were negative for M. ulcerans. Positive and negative controls were positive and negative for M. ulcerans, respectively. The samples were all negative for M, ulcerans. This could mean that the samples did not the Mycobacterium. Conversely, seasonal variance (wet versus dry) may have affected the presence of the microbe in the environment. Environmental contamination may have inhibited the isolation of M. ulcerans. Further sampling should be done to determine the reservoir of this disease in this region. Additionally, follow-up sampling should be completed during the wet season to rule out seasonal variation and culture methods should be developed in order to identify living organisms from environmental samples.