Buruli Ulcer Clinical Trial
— Buruli_PathOfficial title:
A Study of the Pathogenesis and Management of M. Ulcerans Disease, Buruli Ulcer
Verified date | March 2017 |
Source | Kwame Nkrumah University of Science and Technology |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Buruli ulcer is a neglected tropical disease caused by infection with Mycobacterium ulcerans
(Mu) in rural parts of West Africa. It causes large skin ulcers mainly in children aged 5 to
15 years. Access to treatment is limited and many cases present late. There have been major
advances in understanding the mechanism of disease together with improved diagnosis and
management. The aim of the proposed studies is to identify markers predictive of a rapid
response to antibiotic treatment and to investigate the pathogenesis of paradoxical
reactions and oedematous lesions in Mu disease.
Infection with Mu results in a nodule under the skin which enlarges and breaks down to form
an ulcer. This is because Mu produces a toxin that spreads outwards and damages subcutaneous
tissue. In recent years it has been found that antibiotic treatment for 8 weeks with daily
tablets and intramuscular injections heals ulcers. This is unpleasant and it would be better
if the treatment could be shortened. Our previous studies suggest this may be possible.
Therefore a wide range of tests will be investigated in order to identify markers for people
in whom the infection is at an early stage with low numbers of Mu bacteria and low levels of
toxin in the skin. During antibiotic treatment the rate of healing will be measured to find
out which markers are the most reliable.
In some patients new areas of inflammation develop despite treatment and this is called a
paradoxical reaction. The immune response to Mu will be investigated serially during
antibiotic treatment to investigate the cause of paradoxical reactions.
About 15% of patients have oedematous disease, the most severe form of Buruli ulcer. We will
study the amount of Mu toxin produced by the strain of Mu cultured from patients with this
form of the disease.
Hypothesis
- Buruli ulcer patients that heal rapidly/slowly or develop paradoxical reactions with
treatment will have associated predictive viability or serum biomarkers.
- Buruli ulcer patients with oedematous disease are associated with larger amounts of
mycolactone and viable organisms
Status | Active, not recruiting |
Enrollment | 400 |
Est. completion date | January 2018 |
Est. primary completion date | December 15, 2016 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 5 Years and older |
Eligibility |
Inclusion Criteria: - All patients 5 years old or more diagnosed as having Buruli ulcer. - Age-matched household contacts of patients that present with Buruli ulcer and healthy volunteers living in Buruli ulcer non-endemic communities Exclusion Criteria: - Patients aged less than 5 years and those - Unwilling to give informed consent |
Country | Name | City | State |
---|---|---|---|
Ghana | Agogo Presbyterian Hospital | Agogo | Asante Akim North District |
Ghana | Nkawie Government Hospital | Nkawie | Atwima Nwabiangya district |
Ghana | Tepa Government Hospital | Tepa | Ahafo Ano North district |
Lead Sponsor | Collaborator |
---|---|
Kwame Nkrumah University of Science and Technology |
Ghana,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Mycolactone measurement in tissue of diseased subjects | Assessed at baseline, 4, 8, 12, 16 only if lesions are not healed | ||
Other | Rate of healing and time to healing in diseased subjects | The primary outcome measure will be assessed for each participant at the time of healing which will vary for participants | ||
Primary | Measurement of serum/plasma proteins in diseased and healthy subjects | Assessed for diseased participants at baseline, 8, 12, 16 weeks and only at baseline for healthy subjects | ||
Secondary | Viable M. ulcerans and bacterial load measurement in tissue of diseased subjects | Assessed at baseline, 4, 8, 12, 16 only if lesions are not healed |
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