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

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.

Received June 30, 2005. Accepted for publication March 29, 2006.

Acknowledgments: We thank the staff of the IME/Kimpese as well as the staff of the Mycobacteriology Unit of the ITM/Antwerp for patient care and microbiologic analyses.

Financial support: This study was supported by the Damien Foundation (Brussels, Belgium) and the European Commission (International Science and Technology Cooperation Development Program), project no. INCO-CT-2005-051476-BURULICO. Delphin M. Phanzu received a grant from the Directorate General for Development and Cooperation (Brussels, Belgium).

^* Address correspondence to Françoise Portaels, Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium. E-mail: portaels{at}itg.be

Authors’ addresses: Delphin M. Phanzu, Eric A. Bafende, Barthelemy K. Dunda, Desire B. Imposo, and Samuel Z. Nsiangana, Institut Médical Evangélique, Kimpese Hospital, Kimpese, Bas-Congo, Democratic Republic of Congo. Anatole K. Kibadi and Jackie N. Singa, Programme National de Lutte contre l’Ulcère de Buruli, Kinshasa, Democratic Republic of Congo. Wayne M. Meyers, Armed Forces Institute of Pathology, Washington, DC 20306. Patrick Suykerbuyk and Françoise Portaels, Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium, E-mail: portaels{at}itg.be.

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