A statistical model for spatial patterns of Buruli ulcer in the Amansie West district,Ghana

Buruli ulcer (BU), a skin ulceration caused by Mycobacterium ulcerans (MU), is the second most widespread mycobacterium infection in Ghana. Its infection pathway is possibly related to the potable and agricultural water supply. This study aims to identify environmental factors that influence infection in a part of Ghana. It examines the significance of contaminated surface drainage channels and groundwater using conditional autoregressive (CAR) statistical modelling. This type of modelling implies that the spatial pattern of BU incidence in one community depends on the influence of the environment in neighbouring communities. Covariates were included to assess the spatial relationship between environmental risk factors and BU incidence in the study area. The study reveals an association between (a) the mean As content of soil and spatial distribution of BU and (b) the distance to sites of gold mining and spatial distribution of BU. We conclude that both arsenic in the natural environment and gold mining influence BU infection.