Environmental Hypothesis: Arsenic can be a Contributory Factor in Mycobacterium Ulcerans Infection

Abstract: Buruli ulcer (BU), an often-deforming skin and bone disease caused by Mycobacterium ulcerans (MU), is now considered by the World Health Organisation (WHO) to be the third most widespread mycobacterial infection after Tuberculosis and leprosy. However, the reservoir of MU in the environment and the epidemiology of BU are poorly understood. This paper explores the hypothesis that arsenic in the natural environment can be a contributory factor in MU infection. A review and synthesis of the published literature shows: (a) numerous similarities between BU and arsenicosis; (b) spatial coincidences between BU rates and periodic enrichments of arsenic in the environment.