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Ecology and Evolution of Infectious Diseasespathogen control and public health management in low-income countries$
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Benjamin Roche, Hélène Broutin, and Frédéric Simard

Print publication date: 2018

Print ISBN-13: 9780198789833

Published to Oxford Scholarship Online: August 2018

DOI: 10.1093/oso/9780198789833.001.0001

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Interactions between ecological and socio-economic drivers of Buruli ulcer burden in Sub-Saharan Africa: opportunities for an improved control

Interactions between ecological and socio-economic drivers of Buruli ulcer burden in Sub-Saharan Africa: opportunities for an improved control

Chapter:
(p.217) Chapter 14 Interactions between ecological and socio-economic drivers of Buruli ulcer burden in Sub-Saharan Africa: opportunities for an improved control
Source:
Ecology and Evolution of Infectious Diseases
Author(s):

Andes Garchitorena

Matthew H. Bonds

Jean-Francois Guégan

Benjamin Roche

Publisher:
Oxford University Press
DOI:10.1093/oso/9780198789833.003.0014

This chapter provides an overview of the complex interactions between ecological and socioeconomic factors for the development and control of Buruli ulcer in Sub-Saharan Africa. We review key ecological and evolutionary processes driving the environmental persistence and proliferation of Mycobacterium ulcerans, the causative agent, within aquatic environments, as well as transmission processes from these aquatic environments to human populations. We also outline key socioeconomic factors driving the economic and health burden of Buruli ulcer in endemic regions, revealed by reciprocal feedbacks between poverty, disease transmission from exposure aquatic environments and disease progression to severe stages owing to low access to health care. The implications of such insights for disease control, both in terms of limitations of current strategies and directions for the future, are discussed.

Keywords:   neglected tropical diseases, disease ecology, social determinants of health, coupled ecological-economic systems, health equity

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