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However, (early) diagnosis and treatment are challenging. Data on endemicity of <jats:italic>Mycobacterium ulcerans<\/jats:italic> is limited to WHO reports from 2008 to 2011.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients presenting with wounds at Masanga Teaching Hospital were included in a prospective cohort study and scored following the WHO clinical list for Buruli ulcer (BU). Wounds were screened for <jats:italic>M. ulcerans<\/jats:italic> by selective culture on solid and liquid media and loop-mediated isothermal amplification (LAMP) of the <jats:italic>M. ulcerans<\/jats:italic> specific <jats:italic>IS2404<\/jats:italic>.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Between July 2019 and November 2020, 159 patients were included. The median age was 41 years (range: 2\u201392), 34% (54\/159) were female and 56% (89\/159) were literate. The median duration of a wound before admission was 12 months (range: 0-720 months), 87% (137\/159) of lesions were below the knee. Wounds of 37% (58\/159) of the patients were clinically scored as \u2018(very) likely to be Buruli ulcer\u2019. Seven out of 72 patients tested by LAMP were positive for <jats:italic>IS2404<\/jats:italic>, two showed specific melting curves. None of the wound swabs yielded a positive culture for <jats:italic>M. ulcerans<\/jats:italic>. Ninety-eight (62%) patients had a wound-related surgery during this study, 101 (63%) of patients were improving or healed at the time of discharge.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The prevalence of BU based on the WHO scoring system is high in Sierra Leone. National and international awareness, training of healthcare workers, development of in-country bacteriology as well as the furthering of robust molecular and immunological assays could reduce the burden of this neglected tropical disease.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s15010-025-02548-2","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T05:40:27Z","timestamp":1747806027000},"page":"2073-2082","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Suspected Buruli ulcer cases in Tonkolili District, Sierra Leone\u2013 a prospective cohort study"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4012-4177","authenticated-orcid":false,"given":"Jonathan","family":"Vas Nunes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Wassill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"M\u00f6nnink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul-Mac","family":"Falama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Math\u00e9ron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amara","family":"Conteh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxwell","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminata","family":"Sesay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kon","family":"Bolkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin P.","family":"Grobusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frieder","family":"Schaumburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"2548_CR1","doi-asserted-by":"crossref","unstructured":"van Kesteren J, van Duinen AJ, Marah F, van Delft D, Spector AL, Cassidy LD, et al. 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Sierra Leone NTD Master Plan 2023\u20132027. 2023 [cited 2024 Mar 30]; Available from: https:\/\/espen.afro.who.int\/system\/files\/content\/resources\/Sierra_Leone_NTD_Master_Plan_2023_2027_Final.pdf"}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02548-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-025-02548-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-025-02548-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T13:41:21Z","timestamp":1758721281000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-025-02548-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,21]]},"references-count":54,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["2548"],"URL":"https:\/\/doi.org\/10.1007\/s15010-025-02548-2","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,21]]},"assertion":[{"value":"23 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Following clearance by the Masanga Medical Research Unit\u2019s Scientific Review Committee (MMRU-SRC), approval for this study was sought, and granted by the Sierra Leone Ethics and Scientific Review Committee (SLESRC 2019\/January\/29; extension SLESRC 2020\/November\/19). The study was conducted following the principles of the 1964 Helsinki declaration and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Every participant or guardian provided written informed consent to participate in this study and have their data and photograph published in a journal article, prior to any study related procedures.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Lars Wassill is the managing director of AmplexDiagnostics and developed the LAMP. All other authors have no conflict of interest with relevance to the work presented here.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}