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Buruli Ulcer: The Quiet Disease We Must Pay Attention To

b1. method of transmission is unclear but mosquitoes and possum appear to be implicated

For over two decades, RedAid Nigeria has worked quietly but consistently on the frontlines of Buruli ulcer control in southern Nigeria. It is a disease many Nigerians have never heard of, yet for the families it touches, its impact is devastating, long-lasting, and life-altering.

Buruli ulcer (BU) is a neglected tropical disease that primarily affects people living in rural and underserved communities. It is caused by Mycobacterium ulcerans, a bacterium that destroys skin and soft tissue, often without pain in its early stages. Because it begins silently, many people do not seek care until severe ulcers have already formed by then, the damage is extensive, recovery is slow, and disability becomes a real risk.

Although the exact mode of transmission is not fully understood, BU is closely associated with wetland and riverine environments, where stagnant or slow-moving water is common. Children and adults who live, farm, or bathe near these water bodies are particularly vulnerable. What makes the disease especially dangerous is its early presentation: small nodules, plaques, or swelling that appear harmless and painless. Without timely intervention, these lesions progress into large, open ulcers that can eat deep into muscle and bone.

The complications of untreated Buruli ulcer extend beyond physical wounds. Severe scarring, movement limitation, and deformities can permanently alter a person’s life. Children may drop out of school; adults may lose their ability to work. The social consequences; shame, stigma, and isolation often linger long after the wounds have healed.

Early detection remains the cornerstone of effective BU control. When identified in its initial stages, Buruli ulcer can be treated without extensive surgery, significantly reducing the risk of disability. Community-based surveillance, trained frontline health workers, and strong referral systems play a critical role in ensuring that suspected cases are identified early and linked promptly to care.

Treatment has improved considerably over the years. Today, the World Health Organization recommends an eight-week course of combination antibiotics, which has drastically reduced the need for surgical intervention. Community-based treatment models have helped bring care closer to affected populations, reducing the burden of long hospital stays. However, in remote settings, maintaining treatment adherence remains a challenge due to distance, poverty, and limited health infrastructure.

Typical Environment

For advanced cases, surgery and comprehensive wound care are still necessary. Surgical removal of damaged tissue promotes healing and prevents further spread, while proper wound management reduces the risk of secondary infections. Yet treatment does not end when the wound closes.

Rehabilitation and disability prevention are essential but often neglected aspects of Buruli ulcer care. Physiotherapy helps restore movement and prevent long-term functional limitations, while follow-up care and livelihood support enable survivors to reintegrate socially and economically. Unfortunately, these services are frequently underfunded, leaving many patients cured of the disease but struggling to rebuild their lives.

Several challenges continue to undermine BU control efforts. Many patients present late due to painless early symptoms, limited access to healthcare, and deep-rooted traditional beliefs. Stigma and discrimination further delay care, disrupt education and employment, and worsen psychosocial outcomes.

The economic burden on affected families is heavy. Transportation costs, wound care supplies, lost income, and extended caregiving responsibilities often push households deeper into poverty. At the same time, limited research funding and low global prioritisation of Buruli ulcer restrict innovation in diagnosis, prevention, and long-term care.

Buruli ulcer may be neglected, but it is not rare. It may be quiet, but its consequences are loud in the lives it reshapes. At RedAid Nigeria, our decades of work have shown us that addressing Buruli ulcer requires more than medicine; it demands early action, community trust, sustained care, and a commitment to ensuring that no one is left behind because of where they live or how little their disease is understood.

mhCAP NTDs project indicators:

  1. Number of persons who accessed peer wellbeing support (Self-Help Group) – 70

  2. Number of persons reached with anti stigma messages in the community – 30,000

  3. Number of persons affected by NTDs accessing mental health services in PHCs – 100

  4. Number of persons who received livelihood support – 70

 
 
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