Article Sidebar
Article Details
Articles published in the Ghana Medical Journal may not be published elsewhere without the consent of the publishers. Request for consent for reproduction of material published in the Ghana Medical Journal should be addressed to the Editor-in-Chief. The publisher of this Journal reserves the right of copyright of all articles published in the Journal. It should also be understood by all authors that articles approved for publication in the journal are also deemed for publication online by the publisher.
Ghana Medical Journal is an Open Access journal and applies the Creative Commons Attribution (CC BY) license (Creative Commons Attribution License) 4.0 International. See details on the Creative Commons website (https://creativecommons.org/licenses/by/4.0/) to articles and other content published in the Journal.
Main Article Content
In the case of transmission of <i>Mycobacterium ulcerans</i> in Buruli ulcer disease <i>Acanthamoeba </i>species stand accused
Abstract
ultimately require surgery and rehabilitation. The disease is associated with aquatic and swampy environments with the mycobacterium occurring in
biofilms, soil, aquatic insects, fish and wildlife however, the mode of transmission to humans remains an enigma. Current transmission ideas including bites from predatory water bugs and mosquitoes, do not
explain satisfactorily the spasmodic disease distribution in human populations. Here we argue that Acanthamoeba species are the natural hosts of M. ulcerans and are mainly responsible for disease transmission because; (i) Acanthamoebae are known natural hosts of several microbial pathogens including M. marinum, M. avium and Legionella pneumophila,
(ii) culture of slow-to-grow microbial pathogens hosted in nature by Acanthamoeba spp is enhanced when the media is seeded with the protozoa, (iii) acanthamoebae and M. ulcerans share similar bio-ecological and epidemiological settings, (iv) documented evidence that prior growth of L. pneumophila and M. avium in acanthamoebae influences entry mechanisms, intracellular growth and virulence in human monocytes, (v) Acanthamoeba spp also infect humans and cause diseases via routes of openings including broken skin and sites of trauma similar to M. ulcerans
and (vi) M. ulcerans is rather a fastidious intracellular organism as recent analysis of the genome indicate. We argue further that temperature plays a significant role in transmission determining the fate of either the
intracellular microbe or the host cells. Also, Acanthamoeba-pathogen association has a long evolutionary history because the same set of bacterial genes and gene products e.g. in L. pneumophila are
required for survival in both mammalian and protozoan host cells. We suggest that the involvement of Acanthamoeba in the transmission of M. ulcerans to humans better explains the disease's epidemiology.
