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Setting: The epidemiology of tuberculosis (TB) among children in the Democratic Republic of Congo (DRC) is not well known. Objective: This study aimed to describe the trends in TB epidemiology among children in the DRC and to compare these trends in children and adults. Design: Data from the National TB program, the WHO Global TB Report, and a demographic survey of health in the DRC were retrospectively analyzed. The study period was from 1995 to 2014. The notification rate, absolute incidence and incidence rate of TB per 100,000 population were reported. Results: In 2014, 12,785 (12.6% of adult cases) TB cases were reported in children and 101,303 in adults. Among children, 3438 (26.89%) had PTB+; 2828 (22.11%) had PTB–; and 6519 (50.98%) had extrapulmonary TB (EPTB). Children under 5 years had a lower reported prevalence of TB (184 cases). The incidence rate per 100,000 population was 10 in children and 181 in adults. The TB incidence decreased between 2010 (11.47) and 2014 (10.46). The proportion of children in overall cases of PTB+ was 4% to 5% in all districts. Conclusion: Caring for childhood TB remains a challenge in the DRC. Improved diagnostic procedures and effective training of providers who care for childhood TB are needed.

A propos d’un cas, les auteurs illustrent leur experience dans l’utilisation d’une tubulure de perfusion a la place d’une tige de silicone (tige de Hunter) dans un environnement chirurgical a ressources limitees pour la chirurgie secondaire en deux temps des tendons flechisseurs en zone 2 chez un homme de 47 ans, droitier, 5 mois apres un traumatisme devant une absence totale de flexion active des articulations inter-phalangiennes proximales (IPP) et inter-phalangiennes distales (IPD) de 4 doigts longs de la main droite. Lors du 1er temps de reparation, la reconstruction des poulies A2 et A4 a utilise un greffon de reticulum des extenseurs. Une tubulure de perfusion a la place d’un implant en silicone (tige de Hunter) a ete mise en place. Lors du 2e temps, la formation d’un neo-canal digital autour de la tubulure de perfusion a ete observee. La tubulure de la perfusion a ete retiree et remplacee par une greffe de tendon de palmaris longus selon la technique conventionnelle. La kinesitherapie et la reeducation ont encadre la chirurgie. A 6 mois, des progres tres significatifs ont ete observes avec une recuperation complete et totale des amplitudes des mouvements de flexion active des IPP et IPD de 4 doigts longs.

Large Buruliulcer of Right Arm Complicated by Radial Nerve Palsy Treated with Latissimus Dorsi Flap and Triple Tendon Transfer The author reports a case of a large Buruliulcer (Mycobacterium ulcerans infection) of right arm complicated by radial nerve palsy. Mycobacterium ulcerans infection was treated with antibiotics (Rifampicin and Streptomycin) for 8 weeks, as recommended by the World Health Organization. For large Buruliulcer, necrotic tissue after cleaning, Latissimus dorsi flap was performed. Radial nerve palsy was treated by a triple tendon transfer. The transfer of pronatorteres to extensor carpiradial is brevis,flexor carpiulnar is to extensor rdigitorum communis and Palmaris longus to extensor pollicis longus has been made to restore the function of the extension of the wrist, fingers and thumb. Immobilization and rehabilitation framed surgery. The patient recovered the different functions of member repaired. After follow-up of three years, no complications (bone or skin) were observed.

The Buruli ulcer (B. U.) is rampant in many tropical and subtropical countries. In D.R. of Congo, some cases of Buruli ulcer have been reported between 1950 and 1970 in the endemic focus of Songololo-Kimpese (Lower-Congo Province). The objective of this study was to provide some anthropological knowledge for better treatment of this pathology; to confirm the presence of Buruli ulcer in that focus and to describe general caracteristics of the subjects. This disease looked upon as "mbasu" (in the Ndibu population in majority in that focus) is experienced as a malediction, or punishment. The success of a program to fight against Buruli ulcer lies on health education which takes into account the representation systems of diseases.

The Buruli ulcer (BU) rages in a lot of tropical and subtropical countries. In Democratic Republic of Congo, some BU cases were reported between the 50s and 70s. This disease offers resistance to the usual chemotherapy. The only alternative for the treatment remains the surgical one (trimming, wound dressing, graft). The overarching aim of this study, conducted in the province of Lower Congo, is to put forward a surgical therapeutic approach adapted to the precarious conditions met on the ground in our rural areas. The evidence of a Mycobacterium ulcerans infection has been bacteriological and histopathological. The slight skin autograft or "of Davis", in open air or with dressing was performed in 37 patients. After three months this skin autograft in open air has experienced 78.5% of complete healing against 70% for the skin autograft with dressing. The exposure of skin graftings to open air favors an hyperoxygenation which also fights against the Mycobacterium ulcerans, for this latter develops better in an hypoxical area.