1921
Volume 81, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Fifty years after the last report of infections (Buruli ulcer [BU]) in Kasongo Territory, Maniema Province, Democratic Republic of Congo (DRC), we conducted a small-scale cross-sectional survey to assess if this historical BU focus was still active and if so to explore the disease epidemiology. Seventy-five active and inactive BU cases were identified on clinical grounds of which two of 28 BU active cases were laboratory confirmed. We used a modified BU02 form to reconstruct the local disease dynamics and we believe that the horrific conflict in eastern DRC and exceptional flooding were the most likely causes of the re-emergence of the disease. There is a need in the DRC to decentralize and integrate surveillance and control activities at local level to increase the effectiveness of patient management.

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2009-11-01
2017-09-26
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References

  1. Hotez PJ, Molyneux DH, Fenwick A, Kumaresan J, Sachs SE, Sachs JD, Savioli L, 2007. Control of neglected tropical diseases. N Engl J Med 357: 1018–1027.
  2. Walsh DS, Portaels F, Meyers WM, 2008. Buruli ulcer (Mycobacterium ulcerans infection). Trans R Soc Trop Med Hyg 102: 969–978.
  3. World Health Organization, 2008. Buruli ulcer: progress report, 2004–2008. Wkly Epidemiol Rec 17: 145–154.
  4. Janssens PG, Pattyn SR, Meyers WM, Portaels F, 2005. Buruli ulcer: an historical overview with updating to 2005. Bull Seances Acad R Sci Outre Mer 51: 265–299.
  5. The Uganda Buruli Group, 1971. Epidemiology of Mycobacterium ulcerans infection (Buruli ulcer) at Kinyara, Uganda. Trans R Soc Trop Med Hyg 65: 763–775.
  6. Oluwasanmi JO, Solankee TF, Olurin EO, Itayemi SO, Alabi GO, Lucas AO, 1976. Mycobacterium ulcerans (Buruli) skin ulceration in Nigeria. Am J Trop Med Hyg 25: 122–128.
  7. Veitch MG, Johnson PD, Flood PE, Leslie DE, Street AC, Hayman JA, 1997. A large localized outbreak of Mycobacterium ulcerans infection on a temperate southern Australian island. Epidemiol Infect 119: 313–318.
  8. Johnson RC, Makoutodé M, Sopoh GE, Elsen P, Gbovi J, Pouteau LH, Meyers WM, Boko M, Portaels F, 2005. Buruli ulcer distribution in Benin. Emerg Infect Dis 11: 500–501.
  9. Johnson RC, Sopoh GE, Boko M, Zinsou C, Gbovi J, Makoutode M, Portaels F, 2005. Distribution of Mycobacterium ulcerans (Buruli ulcer) in the district of Lalo in Benin. Trop Med Int Health 10: 863–871.
  10. Johnson PD, Azuolas J, Lavender CJ, Wishart E, Stinear TP, Hayman JA, Brown L, Jenkin GA, Fyfe JA, 2007. Mycobacterium ulcerans in mosquitoes captured during outbreak of Buruli ulcer, southeastern Australia. Emerg Infect Dis 13: 1653–1660.
  11. Portaels F, Meyers WM, Ablordey A, Castro AG, Chemlal K, de Rijk P, Elsen P, Fissette K, Fraga AG, Lee R, Mahrous E, Small PL, Stragier P, Torrado E, Van Aerde A, Silva MT, Pedrosa J, 2008. First cultivation and characterization of Mycobacterium ulcerans from the environment. PLoS Negl Trop Dis 2: e178, doi: 10.1371/journal.pntd.0000178.
  12. World Health Organization, 2004. Buruli ulcer disease: Mycobacterium ulcerans infection: an overview of reported cases globally. Wkly Epidemiol Rec 14: 194–199.
  13. Duker AA, Portaels F, Hale M, 2006. Pathways of Mycobacterium ulcerans infection: a review. Environ Int 32: 567–573.
  14. Meyers WM, Connor DH, McCullough B, Bourland J, Moris R, Proos L, 1974. Distribution of Mycobacterium ulcerans infections in Zaire, including the report of new foci. Ann Soc Belg Med Trop 54: 147–157.
  15. Phanzu DM, Bafende EA, Dunda BK, Imposo DB, Kibadi AK, Nsiangana SZ, Singa JN, Meyers WM, Suykerbuyk P, Portaels F, 2006. Mycobacterium ulcerans disease (Buruli ulcer) in a rural hospital in Bas-Congo, Democratic Republic of Congo, 2002–2004. Am J Trop Med Hyg 75: 311–314.
  16. Kibadi K, Panda M, Tamfum JJ, Fraga AG, Longatto Filho A, Anyo G, Pedrosa J, Nakazawa Y, Suykerbuyk P, Meyers WM, Portaels F, 2008. New foci of Buruli ulcer, Angola and Democratic Republic of Congo. Emerg Infect Dis 14: 1790–1792.
  17. Debacker M, Aguiar J, Steunou C, Zinsou C, Meyers WM, Guédénon A, Scott JT, Dramaix M, Portaels F, 2004. Mycobacterium ulcerans disease (Buruli ulcer) in rural hospital, Southern Benin, 1997–2001. Emerg Infect Dis 10: 1391–1398.
  18. Quertinmont MJ, 1959. Etude clinique d’une affection nouvelle à Mycobacterium au Maniema (Congo Belge). Acta Chir Belg 58: 862–892.
  19. Janssens PG, Quertinmont MJ, Sieniawski J, Gatti F, 1959. Necrotic tropical ulcers and mycobacterial causative agents. Trop Geogr Med 11: 293–312.
  20. Bureau de Coordination des Affaires Humanitaires Nations Unies, République Démocratique du Congo, 2005. Mission d’Évaluation des Besoins Humanitaires Province du Maniema. New York: United Nations Office for the Coordination of Humanitarian Affairs, 1–49.
  21. Raucq P, 1952. Notes de géographie sur le Maniema. Mém Inst R Colon Belg Sect Sci-Nat Méd Coll in 8 21: 1–71.
  22. Benoit PL, 1964. Mission de zoologie médicale au Maniema (Congo, Léopoldville). Ann Musée R Afrique Cent Sér in 8 Sci Zool 132: 7–17.
  23. Assemblée Nationale, 2006. Constitution de la République Démocratique du Congo. Zaire: Presse Présidentielle, 1–57.
  24. Pangu KA, 1990. An example of a research project in public health: the Kasongo Project. Ann Soc Belg Med Trop 1: 23–33.
  25. Van Balen H, 1994. The Kasongo project: a case study in community participation. Trop Doct 24: 13–16.
  26. World Health Organization, 2008. Buruli Ulcer; Objective and Strategy for Control and Research. Available at: http://www.who.int/buruli/control/en/. Accessed March 28, 2008.
  27. Eddyani M, Debacker M, Martin A, Aguiar J, Johnson CR, Uwizeye C, Fissette K, Portaels F, 2008. Primary culture of Mycobacterium ulcerans from human tissue specimens after storage in semisolid transport medium. J Clin Microbiol 46: 69–72.
  28. Sizaire V, Nackers F, Comte E, Portaels F, 2006. Mycobacterium ulcerans infection: control, diagnosis, and treatment. Lancet Infect Dis 6: 288–296.
  29. World Health Organization, 2001. Buruli Ulcer. Diagnosis of Mycobacterium ulcerans Disease. Portaels F, Johnson P, Meyers WM, eds. Geneva: World Health Organization. WHO/CDS/ GBUI/2001.4.
  30. Stragier P, Ablordey A, Durnez L, Portaels F, 2007. VNTR analysis differentiates Mycobacterium ulcerans and IS2404 positive mycobacteria. Syst Appl Microbiol 30: 525–530.
  31. Amofah G, Bonsu F, Tetteh C, Okrah J, Asamoa K, Asiedu K, Addy J, 2002. Buruli ulcer in Ghana: results of a national case search. Emerg Infect Dis 8: 167–170.
  32. Noeske J, Kuaban C, Rondini S, Sorlin P, Ciaffi L, Mbuagbaw J, Portaels F, Pluschke G, 2004. Buruli ulcer disease in Cameroon rediscovered. Am J Trop Med Hyg 70: 520–526.
  33. Debacker M, Aguiar J, Steunou C, Zinsou C, Meyers WM, Scott JT, Dramaix M, Portaels F, 2004. Mycobacterium ulcerans disease: role of age and gender in incidence and morbidity. Trop Med Int Health 9: 1297–1304.
  34. Debacker M, Aguiar J, Steunou C, Zinsou C, Meyers WM, Portaels F, 2005. Buruli ulcer recurrence, Benin. Emerg Infect Dis 11: 584–589.
  35. Stienstra Y, van der Graaf WT, Asamoa K, van der Werf TS, 2002. Beliefs and attitudes toward Buruli ulcer in Ghana. Am J Trop Med Hyg 67: 207–213.
  36. Phillips R, Horsfield C, Kuijper S, Lartey A, Tetteh I, Etuaful S, Nyamekye B, Awuah P, Nyarko KM, Osei-Sarpong F, Lucas S, Kolk AH, Wansbrough-Jones M, 2005. Sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans in an assay using punch biopsy specimens for diagnosis of Buruli ulcer. J Clin Microbiol 43: 3650–3666.
  37. Chukwuekezie O, Ampadu E, Sopoh G, Dossou A, Tiendrebeogo A, Sadiq L, Portaels F, Asiedu K, 2007. Buruli ulcer, Nigeria. Emerg Infect Dis 13: 782–783.
  38. Depoortere E, Checchi F, 2006. Pre-emptive war epidemiology: lessons from the Democratic Republic of Congo. Lancet 367: 7–9.
  39. Van Herp M, Parqué V, Rackley E, Ford N, 2003. Mortality, violence and lack of access to healthcare in the Democratic Republic of Congo. Disasters 27: 141–153.
  40. Nackers F, Johnson RC, Glynn JR, Zinsou C, Tonglet R, Portaels F, 2007. Environmental and health-related risk factors for Mycobacterium ulcerans disease (Buruli ulcer) in Benin. Am J Trop Med Hyg 77: 834–836.
  41. Stienstra Y, van der Werf TS, Oosterom E, Nolte IM, van der Graaf WT, Etuaful S, Raghunathan PL, Whitney EA, Ampadu EO, Asamoa K, Klutse EY, te Meerman GJ, Tappero JW, Ashford DA, van der Steege G, 2006. Susceptibility to Buruli ulcer is associated with the SLC11A1 (NRAMP1) D543N polymorphism. Genes Immun 7: 185–189.
  42. ReliefWeb, 1998. Congo Flood Emergency Update. Available at: http://www.reliefweb.int/rw/rwb.nsf/db900sid/ACOS-64C2ZA?OpenDocument&query=congo%20flooding%20appeal201998. Accessed March 16, 2009.
  43. Merritt RW, Benbow ME, Small PL, 2005. Unraveling an emerging disease associated with disturbed aquatic environments: the case of Buruli ulcer. Front Ecol Environ 3: 323–331.
  44. Barker DJ, 1971. Buruli disease in a district of Uganda. J Trop Med Hyg 74: 260–264.
  45. Cleaveland S, Haydon DT, Taylor L, 2007. Overviews of pathogen emergence: which pathogens emerge, when and why? Curr Top Microbiol Immunol 315: 85–111.
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  • Received : 27 Jan 2009
  • Accepted : 10 Jun 2009

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