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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
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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246436/ https://www.ncbi.nlm.nih.gov/pubmed/22216362 http://dx.doi.org/10.1371/journal.pntd.0001402 |
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author | Phanzu, Delphin Mavinga Suykerbuyk, Patrick Imposo, Désiré Bofunga B. Lukanu, Philippe Ngwala Minuku, Jean-Bedel Masamba Lehman, Linda F. Saunderson, Paul de Jong, Bouke C. Lutumba, Pascal Tshindele Portaels, Françoise Boelaert, Marleen |
author_facet | Phanzu, Delphin Mavinga Suykerbuyk, Patrick Imposo, Désiré Bofunga B. Lukanu, Philippe Ngwala Minuku, Jean-Bedel Masamba Lehman, Linda F. Saunderson, Paul de Jong, Bouke C. Lutumba, Pascal Tshindele Portaels, Françoise Boelaert, Marleen |
author_sort | Phanzu, Delphin Mavinga |
collection | PubMed |
description | 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. 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). 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. 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. |
format | Online Article Text |
id | pubmed-3246436 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-32464362012-01-03 Effect of a Control Project on Clinical Profiles and Outcomes in Buruli Ulcer: A Before/After Study in Bas-Congo, Democratic Republic of Congo Phanzu, Delphin Mavinga Suykerbuyk, Patrick Imposo, Désiré Bofunga B. Lukanu, Philippe Ngwala Minuku, Jean-Bedel Masamba Lehman, Linda F. Saunderson, Paul de Jong, Bouke C. Lutumba, Pascal Tshindele Portaels, Françoise Boelaert, Marleen PLoS Negl Trop Dis Research Article 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. 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). 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. 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. Public Library of Science 2011-12-27 /pmc/articles/PMC3246436/ /pubmed/22216362 http://dx.doi.org/10.1371/journal.pntd.0001402 Text en Phanzu et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Phanzu, Delphin Mavinga Suykerbuyk, Patrick Imposo, Désiré Bofunga B. Lukanu, Philippe Ngwala Minuku, Jean-Bedel Masamba Lehman, Linda F. Saunderson, Paul de Jong, Bouke C. Lutumba, Pascal Tshindele Portaels, Françoise Boelaert, Marleen Effect of a Control Project on Clinical Profiles and Outcomes in Buruli Ulcer: A Before/After Study in Bas-Congo, Democratic Republic of Congo |
title | Effect of a Control Project on Clinical Profiles and Outcomes in Buruli Ulcer: A Before/After Study in Bas-Congo, Democratic Republic of Congo |
title_full | Effect of a Control Project on Clinical Profiles and Outcomes in Buruli Ulcer: A Before/After Study in Bas-Congo, Democratic Republic of Congo |
title_fullStr | Effect of a Control Project on Clinical Profiles and Outcomes in Buruli Ulcer: A Before/After Study in Bas-Congo, Democratic Republic of Congo |
title_full_unstemmed | Effect of a Control Project on Clinical Profiles and Outcomes in Buruli Ulcer: A Before/After Study in Bas-Congo, Democratic Republic of Congo |
title_short | Effect of a Control Project on Clinical Profiles and Outcomes in Buruli Ulcer: A Before/After Study in Bas-Congo, Democratic Republic of Congo |
title_sort | effect of a control project on clinical profiles and outcomes in buruli ulcer: a before/after study in bas-congo, democratic republic of congo |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3246436/ https://www.ncbi.nlm.nih.gov/pubmed/22216362 http://dx.doi.org/10.1371/journal.pntd.0001402 |
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