Emerging Buruli Ulcer (Mycobacterium ulcerans infection)-Ambi among the Tiv People in North-Central Nigeria: A Public Health Concern Compounded by Traditional Believes and Ignorance.

Background: Buruli ulcer is of public health concern particularly where the knowledge about the disease, the infectious agent, treatment and control is poor. An advent of an emerging wound ulcer epidemic was reported in North-central Nigeria in 2023. A study was then carried out between December 2023 to August 20204 among the Tiv people of North-central Nigeria who have reported an emerging strange wound ulcer disease among her population. We determined the prevalence and the knowledge about the infection among this population. Methods: Descriptive epidemiological survey was conducted to determine the prevalence and the causative agent of the emerging wound ulcer among the Tiv people. Wound swabs were taken from the ulcers for laboratory confirmation that these infections were indeed those caused by Mycobacterium ulcerans. Results: Of the 1,030 people assessed (392) 38.09 % Presented with a conspicuous wound ulcer, confirmed to be Buruli ulcer caused by M. ulcerans infection. This infection was very significant among the population cutting across all ages, occupation, gender, even educational levels and occupations. Traditional (88.6%) and spiritual (59.4%) means of infection were the dominant means by which the people believed infection can be acquired. Thus, the knowledge of the people about this infection is poor, believing that this infection is likely to be a traditional or spiritual disease rather than a normal infection. Conclusion: Mycobacterium ulcerans infection (Buruli Ulcer) is highly prevalent and fast emerging among the Tiv people of North-central Nigeria. The knowledge about mode of infection and its means of spread is limited and very poor. There is the need for health authorities to intervene, mount health awareness campaigns on the disease, its mode of spread, prevention and control to ameliorate the sufferings of these people and restore confidence among them. This will again help to curb further spread of the infection.