MYCOBACTERIUM ULCERANS DISEASE (BURULI ULCER) IN A RURAL HOSPITAL IN BAS-CONGO, DEMOCRATIC REPUBLIC OF CONGO, 2002–2004

DELPHIN M. PHANZU Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by DELPHIN M. PHANZU in
Current site
Google Scholar
PubMed
Close
,
ERIC A. BAFENDE Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by ERIC A. BAFENDE in
Current site
Google Scholar
PubMed
Close
,
BARTHELEMY K. DUNDA Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by BARTHELEMY K. DUNDA in
Current site
Google Scholar
PubMed
Close
,
DESIRE B. IMPOSO Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by DESIRE B. IMPOSO in
Current site
Google Scholar
PubMed
Close
,
ANATOLE K. KIBADI Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by ANATOLE K. KIBADI in
Current site
Google Scholar
PubMed
Close
,
SAMUEL Z. NSIANGANA Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by SAMUEL Z. NSIANGANA in
Current site
Google Scholar
PubMed
Close
,
JACKIE N. SINGA Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by JACKIE N. SINGA in
Current site
Google Scholar
PubMed
Close
,
WAYNE M. MEYERS Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by WAYNE M. MEYERS in
Current site
Google Scholar
PubMed
Close
,
PATRICK SUYKERBUYK Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by PATRICK SUYKERBUYK in
Current site
Google Scholar
PubMed
Close
, and
FRANÇOISE PORTAELS Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo; Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo; Armed Forces Institute of Pathology, Washington, District of Columbia; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Search for other papers by FRANÇOISE PORTAELS in
Current site
Google Scholar
PubMed
Close
Restricted access

Buruli ulcer (BU), which is caused by Mycobacterium ulcerans, is an important disabling skin disease. Its prevalence is highest in west and central Africa. We report an apparent resurgence of BU in the Bas-Congo Province, Democratic Republic of Congo. During a 28-month period in 2002–2004, the rural hospital of the Institut Médical Evangélique at Kimpese admitted 51 patients suspected of having BU. Bacteriologic, molecular biologic, and histopathologic studies confirmed BU in 36 of these patients. Extensive clinical data, treatment outcomes, and socioeconomic correlations are summarized. Osteomyelitis was an important complication. A multidisciplinary approach to BU control in the Bas-Congo is proposed, aimed primarily at active case detection.

Author Notes

  • 1

    World Health Organization, 2000. Buruli Ulcer-Mycobacterium ulcerans Infection. Asiedu K, Scherpbier R, Raviglione M, eds. Geneva: World Health Organization. WHO/CDS/CPE/GUI/2001.1.

    • PubMed
    • Export Citation
  • 2

    World Health Organization, 2004. Buruli ulcer disease. Mycobacterium ulcerans infection: an overview of reported cases globally. Wkly Epidemiol Rec 79 :194–200.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Van Oye E, Ballion M, 1950. Faudra-t-il tenir compte d’une nou-velle affection à bacilles acido-résistants en Afrique? (Note préliminaire). Ann Soc Belg Med Trop 30 :619–621.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Janssens PG, 1972. Skin ulcers caused by acid-fast bacilli. Marshall J, ed. Essays in Dermatology.Volume 2. Amsterdam: Excerpta Medica: 264–295.

    • PubMed
    • Export Citation
  • 5

    Meyers WM, Connor DH, McCullough B, Bourland J, Moris R, Proos L, 1974. Distribution of Mycobacterium ulcerans infections in Zaïre, including the report of new foci. Ann Soc Belg Med Trop 54 :147–157.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Andersen FO, 1965. Mycobacterial skin ulcers. Clinical experience. Cent Afr J Med 11 :131–135.

  • 7

    Smith JH, 1970. Epidemiologic observations in cases of Buruli ulcer seen in a hospital in the lower Congo. Am J Trop Med Hyg 19 :657–663.

  • 8

    Bafende AE, Lukanu NP, Numbi AN, 2002. Buruli ulcer in an AIDS patient: case report. S Afr Med J 92 :437.

  • 9

    Kibadi K, Tsakala TM, Mputu-Yamba JB, Kashongwe M, Muyembe T, Imposo BB, 2002. Essai thérapeutique de l’association chloramine-métronidazole-nitrofurantoine dans l’ulcère de Buruli surinfecté. Med Afr Noire 49 :239–243.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Bafende AE, Phanzu MD, Imposo BB, 2004. Buruli ulcer in the Democratic Republic of Congo: epidemiology, presentation and outcome. Trop Doc 34 :82–84.

  • 11

    Portaels F, 1989. Epidémiologie des ulcères à Mycobacterium ulcerans. Ann Soc Belg Med Trop 69 :91–103.

  • 12

    Kibadi K, Tsakala TM, Mputu-Yamba JB, Muyembe T, Kashongwe M, Imposo B, Nsiala A, 2003. L’ulcère de Buruli chez les réfugiés Angolais des sites de Kimpese, Bas-Congo, RD Congo. Cahiers Santé 13 :39–41.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    World Health Organization, 2001. Buruli Ulcer. Diagnosis of Mycobacterium ulcerans Disease. Portaels F, Johnson P, Meyers WM, eds. Geneva: World Health Organization. WHO/CDS/CPE/GBUI/2001.4.

    • PubMed
    • Export Citation
  • 14

    Pettit JHS, Marchette NJ, Rees RJW, 1966. Mycobacterium ulcerans infection. Clinical and bacteriological study of the first cases recognized in south east Asia. Br J Dermatol 78 :187–197.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Portaels F, Aguiar J, Fissette K, Fonteyne PA, De Beenhouwer H, De Rijk P, Guédénon A, Lemans R, Steunou C, Zinsou C, Dumonceau JM, Meyers WM, 1997. Direct detection and identification of Mycobacterium ulcerans in clinical specimens by PCR and oligonucleotide-specific capture plate hybridization. J Clin Microbiol 35 :1097–1100.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Yeboah-Manu D, Bodmer T, Mensah-Quainoo E, Owusu S, Ofori-Adjei D, Pluschke G, 2004. Evaluation of decontamination methods and growth media for primary isolation of Mycobacterium ulcerans from surgical specimens. J Clin Microbiol 42 :5875–5876.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Debacker M, Aguiar J, Stenou 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Debacker M, Aguiar J, Stenou 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Bär W, Rüsch-Gerdes S, Richter E, Marquéz de Bär G, Dittmer C, Papsdorf H, Stosiek P, de Rijk PB, Meyers WM, Portaels F, 1998. Mycobacterium ulcerans infection in a child from Angola: diagnosis by direct detection and culture. Trop Med Int Health 3 :189–196.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Pszolla N, Sarkar MR, Strecker W, Kern P, Kinzl L, Meyers WM, Portaels F, 2003. Buruli ulcer: A systemic disease. Clin Infect Dis 37 :e78–e82.

  • 21

    Suykerbuyk P, Phanzu MD, Polman K, Bafende E, Meirte D, Leirs H, Trefois P, Portaels F, 2004. The potential role of freshwater snails, aquatic insects, fish, rodents, lizards and amphibians as reservoirs for Mycobacterium ulcerans. Eighth Maastricht Medical Students Research Conference. Maastricht, The Netherlands: University of Maastricht.

    • PubMed
    • Export Citation
  • 22

    Portaels F, Zinsou C, Aguiar J, Debacker M, de Biurrun E, Guédénon A, Josse R, Lagarrigue V, Silva MT, Steunou C, Meyers WM, 2003. Les atteintes osseuses dans l’ulcère de Buruli: à propos de 73 cas. Bull Seanc Acad R Sci Outre Mer 49 :161–190.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23

    Debacker M, Aguiar J, Steunou C, Zinsou C, Meyers WM, Portaels F, 2005. Buruli ulcer recurrence, Benin. Emerg Infect Dis 11 :584–589.

Past two years Past Year Past 30 Days
Abstract Views 53 53 7
Full Text Views 249 5 0
PDF Downloads 61 2 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save