Fig 1.
Proposed mechanisms of transmission of Mycobacterium ulcerans, the causative agent of Buruli ulcer.
The mode(s) of transmission of Buruli ulcer are still uncertain and are likely to differ between West Africa and Southeast Australia. However, hypotheses such as M. ulcerans contamination via aquatic niches [10], host-to-host transmission between humans and animal reservoirs (including possums) [8], and transmission via insect mechanical vectors (including mosquitoes) [9] have been proposed. These hypotheses are explored in this review. Created with BioRender.com.
Table 1.
Summary of current evidence regarding proposed routes of transmission of Mycobacterium ulcerans in West Africa and Southeast Australia.
Table 2.
Summary of activities and behaviours that influence odds of developing Buruli ulcer infection.
Data were taken from case–control studies conducted in regions of Africa endemic for Buruli ulcer. OR refers to the odds of developing Buruli ulcer in cases compared to noninfected controls for “risk factors” and the odds of not developing Buruli ulcer in noninfected individuals compared to infected cases for “protective factors”.