Infection with Mansonella perstans Nematodes in Buruli Ulcer Patients, Ghana

Abstract

During August 2010-December 2012, we conducted a study of patients in Ghana who had Buruli ulcer, caused by Mycobacterium ulcerans, and found that 23% were co-infected with Mansonella perstans nematodes; 13% of controls also had M. perstans infection. M. perstans co-infection should be considered in the diagnosis and treatment of Buruli ulcer.

Keywords: Buruli ulcer; Ghana; Mansonella perstans; Mycobacterium ulcerans; bacteria; co-infection; filariae; nematodes; parasites.

Figure 1

Mansonella perstans nematode in peripheral blood mononuclear cells from Buruli ulcer patient in Ghana. Cells were stained with Giemsa (original magnification ×1,000). M. perstans nematodes can be distinguished from Loa loa and Wuchereria bancrofti nematodes by relative small size, detection in blood samples obtained during the day, and lack of a sheath.

Figure 2

Survival analysis curve of cumulative healing for patients with Mycobacterium ulcerans infection who were co-infected with Mansonella perstans nematodes compared with those who had M. ulcerans monoinfection, Ghana, August 2010–December 2012. No difference in cumulative healing was found between the 2 groups (p = 0.93 by log-rank test).