TOOLS4BU: New Tools for Early Diagnosis and Decentralized Treatment of Buruli Ulcer

Buruli ulcer (BU) is a necrotizing skin disease caused by infection with Mycobacterium ulcerans. This affliction is most common in central and west Africa, though numbers are also rising in parts of Australia. The treatment of BU relies on early diagnosis in order to prevent long-lasting effects and disabilities, which is problematic in remote regions without laboratory facilities. Moreover, current treatment requires antibiotic therapy over a period of eight weeks, which is similarly challenging in these areas. The objectives of this project are 1) to develop a point-of-care test format that allows decentralized diagnosis without laboratory equipment and 2) to establish a new, fast-acting therapy to circumvent the necessity for long-term treatment.

The current gold standard for BU diagnosis involves polymerase chain reaction (PCR) technology. In order to make testing more accessible in low-resource settings, the researchers are working on adapting a diagnostic enzyme-linked immunosorbent assay to target metabolic products originating from the M. ulcerans bacterium. By generating a point-of-care test, this consortium is circumventing the need for laboratory equipment for the early diagnosis of BU. Furthermore, the team is investigating a simplified therapy option to allow for decentralized treatment even in remote areas. A promising candidate is a repurposed tuberculosis drug named Telacebec. Clinical testing for the treatment of BU with this drug is underway and further candidates are being screened for a possible combination therapy. By combining point-of-care diagnostics and a fast and simplified antibiotic treatment, this research consortium hopes to reduce the long-term suffering, stigmatization and permanent disabilities of patients affected by BU.