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Effect of a control project on clinical profiles and outcomes in buruli ulcer: a before/after study in Bas-Congo, Democratic Republic of Congo.
- Source :
-
PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2011 Dec; Vol. 5 (12), pp. e1402. Date of Electronic Publication: 2011 Dec 27. - Publication Year :
- 2011
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Abstract
- Background: Buruli ulcer (BU) is a necrotizing bacterial infection of skin, subcutaneous tissue and bone caused by Mycobacterium ulcerans. Although the functional impairment caused by BU results in severe suffering and in socio-economic problems, the disease remains largely neglected in Africa. The province of Bas-Congo in Democratic Republic of Congo contains one of the most important BU foci of the country, i.e. the Songololo Territory in the District of Cataractes. This study aims to assess the impact of a BU control project launched in 2004 in the Songololo Territory.<br />Methods: We used a comparative non-randomized study design, comparing clinical profiles and outcomes of the group of patients admitted at the General Reference Hospital (GRH) of the "Institut Médical Evangélique" (IME) of Kimpese 3 years before the start of the project (2002-2004) with those admitted during the 3 years after the start of the project (2005-2007).<br />Results: The BU control project was associated with a strong increase in the number of admitted BU cases at the GRH of IME/Kimpese and a fundamental change in the profile of those patients; more female patients presented with BU, the proportion of relapse cases amongst all admissions reduced, the proportion of early lesions and simple ulcerative forms increased, more patients healed without complications and the case fatality rate decreased substantially. The median duration since the onset of first symptoms however remained high, as well as the proportion of patients with osteomyelitis or limitations of joint movement, suggesting that the diagnostic delay remains substantial.<br />Conclusion: Implementing a specialized program for BU may be effective in improving clinical profiles and outcomes in BU. Despite these encouraging results, our study highlights the need of considering new strategies to better improve BU control in a low resources setting.
- Subjects :
- Adolescent
Adult
Anti-Bacterial Agents administration & dosage
Buruli Ulcer drug therapy
Buruli Ulcer prevention & control
Child
Democratic Republic of the Congo epidemiology
Female
Humans
Male
Middle Aged
Osteomyelitis epidemiology
Osteomyelitis prevention & control
Treatment Outcome
Young Adult
Buruli Ulcer epidemiology
Buruli Ulcer pathology
Communicable Disease Control methods
Subjects
Details
- Language :
- English
- ISSN :
- 1935-2735
- Volume :
- 5
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- PLoS neglected tropical diseases
- Publication Type :
- Academic Journal
- Accession number :
- 22216362
- Full Text :
- https://doi.org/10.1371/journal.pntd.0001402