Mycobacterium ulcerans Infection is commonly called Buruli ulcer, a rapidly emerging skin disease that is often disfiguring and causes severe and lasting morbidity in communities of developing nations. The mode of transmission is not known but is thought to be associated with ecologically disturbed aquatic habitats. Outbreaks of BU are nearly always associated with slow-flowing aquatic habitats, which many times are affected by, or created from;human-made changes to the landscape. The proposed interdisciplinary study will take a novel approach to examining the spatial and temporal patterns of human environmental disturbance on the ecology of aquatic food webs, and model how these changes interact with the etiologic agent responsible for an emerging mycobacterial disease. The data will be synthesized to predict ecological relationships that contribute to the emergence of a bacterial pathogen, making a substantial contribution to our understanding of broader patterns in disease ecology. We propose to determine landscape factors that influence aquatic food web structure and M. ulcerans distribution within and among aquatic habitats of Ghana, Africa. By integrating GIS and remote sensing technologies with established ecological sampling and assessment techniques and molecular diagnostic tools (PCR) we will determine the ecological distribution and potential factors influencing environmental conditions conducive for M. ulcerans occurrence and distribution at 3 hierarchical spatial scales: landscape, habitat and community. Using this multi-scale, multidisciplinary approach we will provide data and generate predictive models to enhance the scientific understanding necessary for the design, implementation, and evaluation of future and existing Buruli ulcer control programs. The collaborative project will also provide opportunities for data dissemination and professional research networks with other countries in West Africa, such as Benin and Cote d'lvoire, and worldwide through annual meetings of the World Health Organization Buruli Ulcer Initiative.
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