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Environmental and Health-Related Risk Factors for Mycobacterium ulcerans Disease (Buruli Ulcer) in Benin

Fabienne Nackers, Roch C. Johnson, Judith R. Glynn, Claude Zinsou, René Tonglet, AND Françoise Portaels^*

We conducted a case-control study to investigate the association between Buruli ulcer (BU) and environmental- and health-related behaviors in southern Benin. Hospital BU cases (N = 324) and sex- and age-matched neighborhood controls (N = 1,173) answered a questionnaire. Regular use of soap for washing, treating injuries with soap or antibiotic powder, and frequent contact with flowing water appeared protective against BU.

Received May 21, 2007. Accepted for publication August 4, 2007.

Acknowledgments: We thank Soeur Julia Aguiar for help and hospitality.

Financial support: This study was financed by the Damien Foundation (Brussels, Belgium). This study was also partly supported by the European Commission, project INCO-CT-2005-051476-BURULICO "Buruli ulcer: multidisciplinary research for improvement of control in Africa."

^* Address correspondence to Françoise Portaels, Nationalestraat 155, 2000 Antwerpen, Belgium. E-mail: portaels{at}itg.be

Deceased.

Authors’ addresses: Fabienne Nackers, Université catholique de Louvain, Ecole de Santé Publique, Clos Chapelle-aux-champs 30/ EPID3058, 1200 Woluwé-Saint-Lambert, Belgium, Telephone: 32-2-7643320, Fax: 32-2-7643328, E-mail: Fabienne.Nackers{at}epid.ucl.ac.be. Roch C. Johnson, Programme National de Lutte contre l’Ulcère de Buruli au Bénin, Ministère de la Santé publique, 06 BP 2572, Cotonou, Benin, Telephone: 229-331827, Fax: 229-337057, E-mail: rochjohnson{at}yahoo.fr. Judith R. Glynn, London School of Hygiene and Tropical Medicine, Infectious Disease Epidemiology Unit, Keppel Street, London WC1E 7HT, UK, Telephone: 44-20-79272423, Fax: 44-20-76368739, E-mail: Judith.Glynn{at}lshtm.ac.uk. Claude Zinsou, Centre Sanitaire et Nutritionnel de Gbemonten, Zagnanado, Benin, Fax: 229-520293. Françoise Portaels, Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium, Telephone: 32-3-2476317, Fax: 32-3-2476333, E-mail: portaels{at}itg.be.