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BURULI ULCER DISEASE IN CAMEROON REDISCOVERED

To assess the magnitude of the Buruli ulcer (BU) problem in Cameroon, we conducted a cross-sectional survey in the Nyong River basin and identified on clinical grounds a total of 436 cases of active or inactive BU (202 and 234, respectively). Swab specimens were taken from 162 active cases with ulcerative lesions and in 135 of these (83.3%) the clinical diagnosis was confirmed by the IS2404 polymerase chain reaction. Most lesions (93%) were located on the extremities, with lower limbs being twice as commonly involved as upper limbs. The age of patients with active BU ranged from 2 to 90 years with a median age of 14.5 years. Vaccination with bacilli Calmette-Guérin appeared to protect children against more severe forms of BU with multiple lesions. We conclude that in Cameroon BU is endemic, at least in the study area, and that a comprehensive control program for BU in Cameroon is urgently needed.

Received February 8, 2003. Accepted for publication May 29, 2003.

Acknowledgments: We thank Dr. Ayissi Christopher (Delegate of Public Health of the Centre Province) for his assistance. We are also grateful to the late Simon Bitoto and Daniel Ze Bekolo (Leprosy District Officers for Ayos and Akonolinga Health Districts), as well as to Petrus Nkamsse and Arlette Ngassam for the invaluable help they gave us in different aspects of this study. We also thank Dr. Thomas A. Smith for helping with the design of a map of the survey area showing prevalence by location of the survey area and Jeniffer Jenkins for editing the manuscript.

Financial support: This study was funded by Aide aux Lépreux Emmaüs-Suisse and Médecins Sans Frontières Switzerland. Françoise Portaels was supported by the Fund for Scientific Research, Flanders (Belgium) (FWO-Vlaanderen contract no. G-0301-01).

Authors’ addresses: Jürgen Noeske, Kolveniersstraat 6, Bus 7, B 2000 Antwerp, Belgium. Christopher Kuaban and Josephine Mbuagbaw, Centre Pasteur du Cameroun, BP 1274, Yaounde, Cameroon. Simona Rondini and Gerd Pluschke, Molecular Immunology, Swiss Tropical Institute, Socinstrasse 57, CH 4002, Basel, Switzerland, Telephone: 41-61-284-8235, Fax.: 41-61-271-8654, E-mail: Gerd.Pluschke{at}unibas.ch. Philippe Sorlin, Centre Pasteur du Cameroun, Yaounde, Cameroon. Laura Ciaffi, BP 30139, Yaoundé, Cameroon. Françoise Portaels, Mycobacteriology Unit, Institute of Tropical Medicine, Nationalestraat 155, B 2000 Antwerp, Belgium.

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