Surveillance of the Buruli Ulcer in The Democratic Republic of Congo (Drc): Preliminary Results (2016–2018) | Biomedgrid llc

Abstract

Context: Buruli ulcer poses a real public health problem, not well known, calling for international mobilization. It is an emerging threat to public health in many rural and inter-tropical regions, and DRC is not immune to this problem. However, improving the visibility of this disease and mobilizing resources are ways to make disease control activities more effective.

Introduction

Buruli ulcer (BU) poses a real public health problem that is not well known, calling for international mobilization [1–3]. It is an emerging threat to public health in many rural, inter-tropical regions [1–3]. The infection often leads to extensive destruction of the skin and soft tissues, with extensive ulceration usually on the limbs and may result in permanent deformity and disability [1–4]. According to partial data from 13 countries, there were 2206 cases in 2017 against 1920 in 2016 as reported by the global report of the World Health Organization (WHO) [1, 2, 3]. In Africa, about 48% of the affected population are children under 15, while in Australia, they account for only 10% of cases and 19% in Japan [1, 2, 3].

Objective

To confirm cases and document Buruli ulcer in the different provinces of DRC.

Sources and Methods

INRB relies on the various health zones of DRC to carry out surveillance of BU.

Sample Collection and Processing Sites

Samples of BU suspects from different provinces of DRC (Kinshasa, Equateur, Haut Uele, Bas Uele, Maniema and Kongo Central) were included in the study. These samples were registered in the INRB mycobacteria laboratory from January 1, 2016 to December 31, 2018. Samples were analyzed by Ziehl-Nelsen and real-time PCR for case confirmation.

Data Processing

The data were recorded in the laboratory register and then transferred to the Excel software. Data comparison was done using the Chi-square test and the significance level was set at 5% and the 95% confidence interval (CI).

Discussion

Surveillance of BU is of paramount importance, as people affected with the disease can end up with more or less significant disabilities for life [1, 2, [3, 4, 5, 6, 7, [8, 9, 10]. And so, confirmation of cases by molecular testing appears both as a necessity and a priority [1, 2, [3, 4, 5, 6, 7, [8, 9, 10]. The purpose of the surveillance is to confirm cases and to document the BU in suspected provinces in order to allow a better case management. This surveillance during the three years shows essentially an overall proportion of 26.2% PCR positive samples and in Ziehl — Nelsen, the proportion was low (7.2%). These results corroborate those in the literature which reports that the ZN is less sensitive [1, 2, 3].

Conclusion

Confirmation of cases using laboratory methods, gene amplification (PCR) or direct examination of smears, is an essential aspect in the overall management of the disease because the results obtained can guide a set of short-term and medium-term actions to limit the adverse effects of the disease on populations.

Conflict of interest

None.

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