Buruli Ulcer (BU) is a debilitating disease that mainly affects the skin but which can also affect the bone. The causative agent is called Mycobacterium ulcerans, which although different, belongs to the same family of organisms that cause leprosy and tuberculosis. This affection is one of the most common mycobacterial diseases in human health. Several cases of BU have been identified in at least 26 countries in the African Region since the early 1940s. However, in recent years, an increasing number of cases have been recorded in nearly all Western Africa countries, along the Gulf of Guinea. The causative agent is Mycobacterium ulcerans. For it to cause disease, it must either be transmitted from one infected individual directly to another (e.g.; direct contact) or through the environment (e.g.; via an intermediate host) to a susceptible host. It must also have the capability of surviving and multiplying in either the environment or the host or in both.

Generally, the reservoir of infection is not exactly known but is believed to be either the sick individual or the environment, especially marshy soil and vegetation along slow-flowing streams and rivers, or perhaps an intermediate host that thrives in such environment conditions. The latent period for infection to progress to disease in the susceptible host is also not well known. The mode of transmission is not entirely known. Recent evidence suggests that certain aquatic insects (aquatic bug) belonging to the genus Naucoris and Diplonychus may be involved in the transmission of the infection. The causative agent is commonly introduced into the skin (from surface contamination) through traumatic breaches in the skin (irrespective of size). However, it is not well understood whether infection can occur directly through the intact skin, after an insect bite, or by direct person –to-person contact.