Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017
Uncertainty regarding transmission pathways and control measures makes prompt presentation and diagnosis for Buruli ulcer critical. To examine presentation and diagnosis delays in Victoria, Australia, we conducted a retrospective study of 703 cases notified between 2011 and 2017, classified as resid...
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doaj-0f81ff81b9654ec2b66bd3be07dd31d12020-11-25T01:49:38ZengMDPI AGTropical Medicine and Infectious Disease2414-63662019-07-014310010.3390/tropicalmed4030100tropicalmed4030100Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017Shaun P. Coutts0Colleen L. Lau1Emma J. Field2Michael J. Loftus3Ee Laine Tay4Health Protection Branch, Victorian Department of Health and Human Services, Melbourne, Victoria 3000, AustraliaResearch School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, AustraliaResearch School of Population Health, Australian National University, Canberra, Australian Capital Territory 2601, AustraliaAlfred Health, Melbourne, Victoria 3000, AustraliaHealth Protection Branch, Victorian Department of Health and Human Services, Melbourne, Victoria 3000, AustraliaUncertainty regarding transmission pathways and control measures makes prompt presentation and diagnosis for Buruli ulcer critical. To examine presentation and diagnosis delays in Victoria, Australia, we conducted a retrospective study of 703 cases notified between 2011 and 2017, classified as residing in an endemic (Mornington Peninsula; Bellarine Peninsula; South-east Bayside and Frankston) or non-endemic area. Overall median presentation delay was 30 days (IQR 14−60 days), with no significant change over the study period (<i>p</i> = 0.11). There were significant differences in median presentation delay between areas of residence (<i>p</i> = 0.02), but no significant change over the study period within any area. Overall median diagnosis delay was 10 days (IQR 0−40 days), with no significant change over the study period (<i>p</i> = 0.13). There were significant differences in median diagnosis delay between areas (<i>p</i> < 0.001), but a significant decrease over time only on the Mornington Peninsula (<i>p</i> < 0.001). On multivariable analysis, being aged <15 or >65 years; having non-ulcerative disease; and residing in the Bellarine Peninsula or South-East Bayside (compared to non-endemic areas) were significantly associated with shorter presentation delay. Residing in the Bellarine or Mornington Peninsula and being notified later in the study period were significantly associated with shorter diagnosis delay. To reduce presentation and diagnosis delays, awareness of Buruli ulcer must be raised with the public and medical professionals, particularly those based outside established endemic areas.https://www.mdpi.com/2414-6366/4/3/100Buruli ulcerAustraliaepidemiologyMycobacterium ulceransskin ulcerTuberculosis and other mycobacteria |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Shaun P. Coutts Colleen L. Lau Emma J. Field Michael J. Loftus Ee Laine Tay |
spellingShingle |
Shaun P. Coutts Colleen L. Lau Emma J. Field Michael J. Loftus Ee Laine Tay Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017 Tropical Medicine and Infectious Disease Buruli ulcer Australia epidemiology Mycobacterium ulcerans skin ulcer Tuberculosis and other mycobacteria |
author_facet |
Shaun P. Coutts Colleen L. Lau Emma J. Field Michael J. Loftus Ee Laine Tay |
author_sort |
Shaun P. Coutts |
title |
Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017 |
title_short |
Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017 |
title_full |
Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017 |
title_fullStr |
Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017 |
title_full_unstemmed |
Delays in Patient Presentation and Diagnosis for Buruli Ulcer (<i>Mycobacterium ulcerans</i> Infection) in Victoria, Australia, 2011–2017 |
title_sort |
delays in patient presentation and diagnosis for buruli ulcer (<i>mycobacterium ulcerans</i> infection) in victoria, australia, 2011–2017 |
publisher |
MDPI AG |
series |
Tropical Medicine and Infectious Disease |
issn |
2414-6366 |
publishDate |
2019-07-01 |
description |
Uncertainty regarding transmission pathways and control measures makes prompt presentation and diagnosis for Buruli ulcer critical. To examine presentation and diagnosis delays in Victoria, Australia, we conducted a retrospective study of 703 cases notified between 2011 and 2017, classified as residing in an endemic (Mornington Peninsula; Bellarine Peninsula; South-east Bayside and Frankston) or non-endemic area. Overall median presentation delay was 30 days (IQR 14−60 days), with no significant change over the study period (<i>p</i> = 0.11). There were significant differences in median presentation delay between areas of residence (<i>p</i> = 0.02), but no significant change over the study period within any area. Overall median diagnosis delay was 10 days (IQR 0−40 days), with no significant change over the study period (<i>p</i> = 0.13). There were significant differences in median diagnosis delay between areas (<i>p</i> < 0.001), but a significant decrease over time only on the Mornington Peninsula (<i>p</i> < 0.001). On multivariable analysis, being aged <15 or >65 years; having non-ulcerative disease; and residing in the Bellarine Peninsula or South-East Bayside (compared to non-endemic areas) were significantly associated with shorter presentation delay. Residing in the Bellarine or Mornington Peninsula and being notified later in the study period were significantly associated with shorter diagnosis delay. To reduce presentation and diagnosis delays, awareness of Buruli ulcer must be raised with the public and medical professionals, particularly those based outside established endemic areas. |
topic |
Buruli ulcer Australia epidemiology Mycobacterium ulcerans skin ulcer Tuberculosis and other mycobacteria |
url |
https://www.mdpi.com/2414-6366/4/3/100 |
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