Comprehensive Case–Control Study of Protective and Risk Factors for Buruli Ulcer, Southeastern Australia

To examine protective and risk factors for Buruli ulcer (BU), we conducted a case–control study of 245 adult BU cases and 481 postcode-matched controls across BU-endemic areas of Victoria, Australia. We calculated age- and sex-adjusted odds ratios for socio-environmental, host, and behavioral factor...

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Bibliographic Details
Published in:Emerging infectious diseases 2023-10, Vol.29 (10), p.2032-2043
Main Authors: McNamara, Bridgette J, Blasdell, Kim R, Yerramilli, Arvind, Smith, Ina L, Clayton, Simone L, Dunn, Michael, Tay, Ee Laine, Gibney, Katherine B, Waidyatillake, Nilakshi T, Hussain, Mohammad A, Muleme, Michael, O'Brien, Daniel P, Athan, Eugene
Format: Article
Language:English
Subjects:
Age
BCG
BCG vaccines
Behavior
Buruli ulcer
Case studies
case-control studies
Comprehensive Case–Control Study of Protective and Risk Factors for Buruli Ulcer, Southeastern Australia
Diabetes
Disease
Insect bites
Medical research
Medicine, Experimental
Missing data
Mosquitoes
Mycobacterium
Mycobacterium ulcerans
Ponds
Prevention
Protective clothing
protective factors
Questionnaires
Risk factors
Skin
Trauma
Ulcers
Vaccination
Water use
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Summary:To examine protective and risk factors for Buruli ulcer (BU), we conducted a case–control study of 245 adult BU cases and 481 postcode-matched controls across BU-endemic areas of Victoria, Australia. We calculated age- and sex-adjusted odds ratios for socio-environmental, host, and behavioral factors associated with BU by using conditional logistic regression. Odds of BU were >2-fold for persons with diabetes mellitus and persons working outdoors who had soil contact in BU-endemic areas (compared with indoor work) but were lower among persons who had bacillus Calmette–Guérin vaccinations. BU was associated with increasing numbers of possums and with ponds and bore water use at residences. Using insect repellent, covering arms and legs outdoors, and immediately washing wounds were protective; undertaking multiple protective behaviors was associated with the lowest odds of BU. Skin hygiene/protection behaviors and previous bacillus Calmette–Guérin vaccination might provide protection against BU in BU-endemic areas.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid2910.230011