The location of Australian Buruli ulcer lesions—Implications for unravelling disease transmission

Abstract

Background: Buruli ulcer (BU), caused by Mycobacterium ulcerans, is increasing in incidence in Victoria, Australia. To improve understanding of disease transmission, we aimed to map the location of BU lesions on the human body. Methods: Using notification data and clinical records review, we conducted a retrospective observational study of patients diagnosed with BU in Victoria from 1998–2015. We created electronic density maps of lesion locations using spatial analysis software and compared lesion distribution by age, gender, presence of multiple lesions and month of infection. Findings: We examined 579 patients with 649 lesions; 32 (5.5%) patients had multiple lesions. Lesions were predomi..