{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T21:46:51Z","timestamp":1791323211770,"version":"4.3.1"},"reference-count":78,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2001,12,21]],"date-time":"2001-12-21T00:00:00Z","timestamp":1008892800000},"content-version":"vor","delay-in-days":173,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2001,7]]},"abstract":"<jats:p> <jats:italic>Mycobacterium ulcerans<\/jats:italic> disease, also known as Buruli ulcer (BU), is a disease of subcutaneous fat tissue. BU is prevalent in riverine and swamp areas of the tropical zone in Africa, Asia and South America, and a few scattered foci in Australia. The mode of transmission of <jats:italic>M. ulcerans<\/jats:italic> has not been fully elucidated, but inoculation into the subcutaneous tissues probably occurs through penetrating skin trauma. BU has not been linked with HIV infection. Antimycobacterial drug treatment is ineffective, and treatment is surgical. Patients eventually develop scars and contractures, with resulting disabilities, and the disease imposes a large burden on affected populations. The incidence of BU has dramatically increased in West African countries over the last decade. There is an urgent need for research into host and environmental risk factors for BU in order to develop effective strategies to combat this disease. We review possible genetic host susceptibility factors for BU that are relevant in other mycobacterial diseases: natural resistance\u2010associated macrophage protein\u20101 (<jats:italic>NRAMP\u20101<\/jats:italic>), HLA\u2010DR, vitamin D<jats:sub>3<\/jats:sub> receptor, mannose binding protein, interferon\u2010gamma (IFN\u2010\u03b3) receptor, tumour necrosis factor alpha (TNF\u2010\u03b1), interleukin (IL)\u20101\u03b1, 1\u03b2 and their receptor antagonists; and IL\u201012. <jats:italic>Schistosoma haematobium<\/jats:italic> infection is highly endemic in many BU foci in West Africa, with a striking increase in transmission after river dams were constructed. This observation, and the observations from interaction of schistosomiasis and tuberculosis, have fuelled our hypothesis that schistosomiasis is a risk factor for BU by driving the host immune response towards a predominantly Th\u20102 pattern, away from a Th\u20101 preponderant protection against mycobacterial infection. If the latter hypothesis is confirmed, enhanced schistosomiasis control should impact on BU.<\/jats:p>","DOI":"10.1046\/j.1365-3156.2001.00746.x","type":"journal-article","created":{"date-parts":[[2003,3,12]],"date-time":"2003-03-12T21:37:16Z","timestamp":1047505036000},"page":"554-562","source":"Crossref","is-referenced-by-count":65,"title":["Susceptibility to development of <i>Mycobacterium ulcerans<\/i> disease: review of possible risk factors"],"prefix":"10.1111","volume":"6","author":[{"given":"Y.","family":"Stienstra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. T. A.","family":"Van Der Graaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. J.","family":"Te Meerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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