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Lepra und Buruli-Ulkus

Bedeutung der „vernachlässigten tropischen Erkrankungen“ für Kinder weltweit

Leprosy and Buruli ulcer

Significance of neglected tropical diseases for children worldwide

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Zusammenfassung

Hintergrund

Trotz internationaler Bemühungen zu Kontrolle und Elimination vernachlässigter tropischer Erkrankungen („neglected tropical diseases“, NTD) stellen diese für viele in Armut lebende Menschen nach wie vor eine massive Bedrohung dar. Lepra und Buruli-Ulkus, 2 mykobakterielle Erkrankungen, betreffen noch heute teilweise überproportional die pädiatrische Bevölkerung. Fälle in Deutschland werden vereinzelt bei Migranten diagnostiziert.

Ziel der Arbeit

Spät behandelte Fälle münden häufig in chronische Verläufe mit bleibenden Behinderungen. Exemplarisch wird auf die Herausforderungen bezüglich Übertragung, klinischer Betreuung, Behandlung und Prävention von Behinderungen sowie auf aktuelle Forschungsthemen eingegangen.

Material und Methoden

Die Arbeit beruht auf einer selektiven Literaturrecherche bei PubMed und in der WHO-Dokumentenbank sowie auf persönlicher Feld- und Klinikerfahrung beider Autorinnen mit Patientenkontakt und Austausch mit Gesundheitspersonal vor Ort.

Schlussfolgerung

Langfristige Investitionen in Forschung und Stärkung von Strukturen der Gesundheitssysteme in Endemiegebieten von Lepra und Buruli-Ulkus, mit Fokus auf die Ausbildung von Gesundheitspersonal, können durch Früherkennung und Einleitung adäquater Therapie bei komplizierten Krankheitsverläufen chronische Behinderungen verhindern helfen. Das Wissen um Übertragung, klinische Erscheinungsbilder, verschiedene Verlaufsformen und Behandlungsmöglichkeiten ist relevant für Pädiater, die Patienten mit Migrationshintergrund betreuen.

Abstract

Background

Despite international efforts to control and eliminate neglected tropical diseases, these diseases still represent a considerable risk to people living in poverty conditions. The mycobacterial infections leprosy and Buruli ulcer are sometimes a disproportional threat to the pediatric population. In Germany, cases are mainly observed among migrants.

Aim

Cases which are discovered late often follow a chronic course and can frequently result in different forms of disabilities. Diseases such as leprosy and Buruli ulcer represent a challenge with regard to transmission, clinical care, treatment and prevention of disabilities and are discussed in this article with a focus on the latest research results.

Material and methods

This study was based on a selective literature search in PubMed and World Health Organization (WHO) documents online, supported by personal experiences of the authors in the field and in clinics, as well as personal exchanges with healthcare staff on site.

Conclusion

Prevention of disability can be achieved by long-term investment in research and supporting healthcare systems in regions where leprosy and Buruli ulcer are endemic as well as more research. Training healthcare personnel in early diagnosis plays a key role in a timely initiation of adequate treatment. Knowledge of transmission, the clinical presentation, courses of the disease and treatment options is essential for pediatricians treating migrants.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Adamczick und E.-M. Schwienhorst geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Institut für Epidemiologie, Biostatistik und Prävention, Universität Zürich, Hirschengraben 84, 8001, Zürich, Schweiz

    C. Adamczick DTM&H, MIH

  2. Deutsche Lepra- und Tuberkulosehilfe e. V., Raiffeisenstr. 3, 97080, Würzburg, Deutschland

    E.-M. Schwienhorst DTMPH, MScIH

Authors
  1. C. Adamczick DTM&H, MIH
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  2. E.-M. Schwienhorst DTMPH, MScIH
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Correspondence to C. Adamczick DTM&H, MIH or E.-M. Schwienhorst DTMPH, MScIH.

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Adamczick, C., Schwienhorst, EM. Lepra und Buruli-Ulkus. Monatsschr Kinderheilkd 163, 1138–1148 (2015). https://doi.org/10.1007/s00112-015-3378-8

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