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Time to wound healing and determinants of delayed wound healing among Buruli ulcer patients in Nigeria.

AO Meka
JN Chukwu
JN Chukwu
CC Nwafor
MI Njoku
N Ekeke
NN Murphy-Okpala
CC Eze
OE Ezeakile
EN Ossai
KN Ukwaja


Background: Little is known about the healing time of ulcers in Buruli Ulcer (BU) and its determinants among BU patients in endemic settings.
Objective: The objective of this study was to evaluate the healing time and determinants of prolonged wound healing among BU patients in Nigeria.
Methods: This was a prospective cohort study of all BU patients managed in BU treatment centres in three states in Nigeria during April 2017 to August 2019.
Results: A total of 46 BU patients were enrolled during the study period; 25 (54.3%) were male, 30 (65.2%) were adults, and 43 (93.5%) of the participants presented as new case. Also, 42 (91.3%) presented with ulcer, 40 (87.0%) had single lesion, 38 (82.6%) had lesions occurring on the lower limb, and 26 (56.5%) presented as advanced ulcer lesions that are more than 15cm in diameter (category III lesion). The overall median (IQR) healing time was 109 (60, 146) days. The median healing time did not differ by gender, age group, HIV status or patient classification (P >0.05). However, the median healing time for patients with limitation of movement at diagnosis was 146 days, compared with 69 days for patients without limitation of movement at diagnosis (P = 0.028). Also, the median healing time was significantly associated with duration of the BU illness (P = 0.009).
Conclusions: In Nigerian patients with BU, the time to complete healing of lesions is generally long. We found that duration of BU illness and having a limitation of movement at diagnosis were associated with longer healing time.

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