The accurate diagnosis of Buruli ulcer – one of the most devastating and debilitating neglected tropical diseases – may become common practice in a near future.
Researchers at Harvard University in the United States have devised a rapid diagnostic test using thin-layer chromatography to detect mycolactone, the toxin that causes tissue damage in Buruli ulcer1. Thin-layer chromatography is a commonly used technique in chemistry for identifying compounds in a given mixture. But in this test, researchers used boronate-assisted fluoroscent thin-layer chromatography (F-TLC) to selectively detect mycolactone when visualized with ultraviolet light.
They were able to read the results within one hour.
This simple test has the potential to become an important tool for field workers involved in Buruli ulcer case detection and treatment.
At the moment, clinical diagnosis of Buruli ulcer relies on well-trained and experienced health professionals. Polymerase chain reaction (PCR) is the most widely used diagnostic test because of its high sensitivity but PCR can be done only in reference laboratories, remote from affected communities.
Significant progress has been made in treating Buruli ulcer over the past few years. WHO recommends combined antibiotics treatment which when given in right doses is highly effective, with a cure rate of almost 80% with antibiotics alone.
An urgent research priority has been the development of a rapid point-of-care diagnostic test.
“Ten years ago, the treatment of Buruli ulcer relied almost entirely on surgery, often requiring wide radical excision and in some cases amputation of limbs” says Dr Kingsley Asiedu, Medical Officer at WHO’s Department of Control of Neglected Tropical Diseases “We hope that the TLC method, once validated in a planned clinical trial, it can be implemented initially at district hospital laboratories to reinforce accurate diagnosis and treatment of patients.”
Buruli ulcer is an ulcerative skin disease caused by the bacterium Mycobacterium ulcerans, which belongs to the same family of organisms that cause leprosy and tuberculosis.
Buruli ulcer has been reported in over 30 countries, but only half of these countries regularly report data to WHO. Most people affected are children under 15 years of age who live in poor rural communities.
It often starts as painless nodules, usually on the arms and legs. These then develop into large ulcers with a whitish-yellow base. Buruli ulcer can be cured with early detection and a combination of antibiotics. But, if poorly managed, the condition can lead to permanent disfigurement and disability. For more infectious disease news and information, visit and “like” the Infectious Disease News Facebook page