Scholarly article on topic 'Prevalence and distribution of Buruli ulcer in the Songololo Territory, Democratic Republic of Congo'

Prevalence and distribution of Buruli ulcer in the Songololo Territory, Democratic Republic of Congo Academic research paper on "Health sciences"

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Academic research paper on topic "Prevalence and distribution of Buruli ulcer in the Songololo Territory, Democratic Republic of Congo"

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15th 1C1D Abstracts / International Journal of Infectious Diseases 16S (2012) e158-e316

Table 1

Prevalence of Buruli ulcer in the Territory of Songololo, July-August 2008

Health Zone Population Number Number Number Global Active BU Inactive

BU case Active BU Inactive preva- preva- BU

_Total_UB_lence/105 lence/105 prevalence/105

Kimpese 146,108 376 141 235 257.3 96.5 160.8

Nsona-Mpangu 91,310 399 118 281 437.0 129.2 307.7

Total 237,418 775 259 516 326.4 109.1 217.3

Background: Cutaneous infection by Mycobacterium ulcerans, also known as Buruli ulcer (BU), represents the third most common mycobacterial disease in the world after tuberculosis and leprosy. The General Reference Hospital (GRH) of the "Institut Médical Evangélique" (IME) of Kimpese, located in Songololo, launched a BU control project in 2004. Although a recent study have shown a strong increase in the number of admitted BU cases after the start of the Project, data on the exact prevalence and burden of disease in the Territory was lacking. This study aimed to assess the prevalence and the distribution of BU, and to determine the project coverage in the Songololo Territory.

Methods: We conducted a two-month (July-August 2008) cross-sectional survey using the door to door method simultaneously in the two rural health zones (RHZ) of the Songololo Territory (RHZ of Kimpese and Nsona-Mpangu), containing each twenty health areas. Cases were defined clinically as active (evolutive) BU and inactive (healed) BU in accordance with WHO-case definitions.

Results: Out of a total population of 237,418 inhabitants, 775 BU patients were detected with 259 active and 516 inactive cases (Table 1). The overall prevalence of BU in Songololo Territory was 326.4/100,000 inhabitants, varying from 0 to 2751.5/100,000 inhabitants between health areas. The geographical distribution is presented in Figure 1. Of the 259 patients with active BU detected, 25 were admitted in the GRH IME/Kimpese from January to August 2008. Thus, the project coverage was 10% only.

0 S 1Û 20 3D 40

Distribution of Buruli ulcer in the Songololo Territory, July-August 2008.

Conclusion: Our study highlights the need of considering new control strategies which are both socially and financially acceptable and appropriate for the concerned communities. Decentralization and integration of BU control activities may improve access to diagnosis and care at the most peripheral level of the health system. A close collaboration between the BU control project and the health zones is essential for the implementation of a simple, functional,

Type: Poster Presentation

Final Abstract Number: 47.030

Session: Tuberculosis & Other Mycobacterial Infections

Date: Friday, June 15,2012

Time: 12:45-14:15

Room: Poster & Exhibition Area

Prevalence and distribution of Buruli ulcer in the Songololo Territory, Democratic Republic of Congo

D. Phanzu Mavinga1-*, P. Suykerbuyk2, P. Lukanu Ngwala3,J.-B. Minuku Masamba4, P. Saunderson5, P. Lutumba Tshindele6, F. Portaels7, M. Boelaert2

1 Institut Médical Evangélique (IME) of Kimpese, Kimpese, Bas-Congo, Congo, Democratic Republic of

2 Institute of Tropical Medicine, Antwerp, Belgium

3 Health Zone of Kimpese, Kimpese, Bas-Congo, Congo, Democratic Republic of

4 Health Zone of Nsona Mpangu, Nsona Mpangu, Bas-Congo, Congo, Democratic Republic of

5 American Leprosy Missions, Greenville, SC, USA

6 Institut National de Recherche Biomeïdicale, Kinshasa, Congo, Democratic Republic of

7 Institute of Tropical Medicine, Antwerp, Belgium

15th 1C1D Abstracts / International Journal of Infectious Diseases 16S (2012)e158-e316

and efficient active surveillance system in a resource limited context.

http://dx.doi.org/10.1016/j.ijid.2012.05.964 Type: Poster Presentation

Final Abstract Number: 47.031

Session: Tuberculosis & Other Mycobacterial Infections

Date: Friday, June 15,2012

Time: 12:45-14:15

Room: Poster & Exhibition Area

Drug resistant tuberculosis in urban Thai children: a 10 year review

W. Punpanich1-*, R. Rattanasataporn2, V. Treeratweeraphong2

1 Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Bangkok, Thailand

2 Queen Sirikit National Institute of Child Health, Bangkok, Thailand

Background: Problem of drug resistant tuberculosis (DR-TB) has currently gained a major concern in magnitude. In the settings where the rates of DR-TB may be high, initial treatment regimen may be modified by knowledge of the resistance patterns. We aimed to determine the prevalence, susceptibility pattern, and risk factors of drug resistant tuberculosis in pediatric patients.

Methods: Retrospective descriptive study was conducted in children (0-18 years) receiving care at Queen Sirikit National Institute of Child Health who had positive culture and available susceptibility pattern of M. tuberculosis. Drug resistant tuberculosis (DR-TB) was defined as resistance to at least one of antituberculosis drugs.

Results: Susceptibility results were available in 78 cases (85.7%) out of 91 positive cultures for M. tuberculosis. The sensitivity of tuberculin test using the cut-off point of 10 mm. induration for non-HIV infected patient, and 5 mm. induration for HIV infected patients were 71.4% and 14.3% respectively. Resistance to at least one anti-tuberculosis drug were found in 22 cases (28.2%) for which streptomycin resistance being the most common (21.7%) followed by isoniazid (11.5%) and rifampicin (5.1%). Multi-drug resistance (MDR), i.e. resistance to at least both isoniazid and rifampicin, was observed in 3 cases (3.8%) of cases. A history of previous treatment and bone and joint involvement were significantly higher for DR-TB cases: 18.2% vs. 1.8%, p = 0.0078 and 22.7 vs. 1.8%, p = 0.0018, for DR-TB and drug susceptible-tuberculosis, respectively. Cases with DR-TB were significantly less likely to complete their treatment course compared to their counterpart (54.5% vs. 87.5%, p = 0.0018). No significant differences in resistance rate by age, gender, clinical presentations, HIV serostatus was observed. Case fatality rates were 1.7% and 4.5% for drug susceptible and drug resistant tuberculosis.

Conclusion: The sensitivity of tuberculin skin test in detecting culture-proven tuberculosis test was rather low among both HIV infected and non-HIV infected children. The rates of isoniazid and streptomycin resistance are causes of concern. History of previous treatment, involvement of bone and joint were associated with drug resistant tuberculosis. Ethambutol may be preferable compared to streptomycin in an empirical treatment regimen due to the high rate of streptomycin resistance.

Type: Poster Presentation

Final Abstract Number: 47.032

Session: Tuberculosis & Other Mycobacterial Infections

Date: Friday, June 15,2012

Time: 12:45-14:15

Room: Poster & Exhibition Area

Tuberculosis in prisoners in four reclusion centers in Medellin and Bucaramanga, Colombia. 2010-2011

Z. Rueda1-*, L.López2, LA.Vélez1, D.M.Marín1, M.R. Giraldo3, H. Pulido4, L.C. Orozco5, F. Montes6, D. Villa-Villa7, M.P. Arbeláez1

1 Universidad de Antioquia, Medellin, Colombia

2 Universidad de Antioquia, Medellín, Colombia

3 Gobernación de Antioquia, Medellin, Colombia

4 Alcaldía de Bello, Bello, Colombia

5 Universidad Industrial de Santander, Bucaramanga, Colombia

6 Alcaldía de Medellín, Medellín, Colombia

7 Gobernación de Santander, Bucaramanga, Colombia

Background: Jails are considered reservoirs of Tb, therefore, an important threat to public health. Objective: to determine the incidence and epidemiology ofTb in prisoners in fourjails, two of each for male and female inmates.

Methods: Prospective cohort study. All prisoners with respiratory symptoms and their personal contacts were evaluated. After signed consent forms, we collected three spontaneous sputum and blood samples on consecutive days. Auramine-rodhamine stain and cultures in thin layer agar, Lowestein-Jensen and MGIT were performed. Additionally, susceptibility tests were performed for first line drugs and HIV testing. We also collected socio-demographic and clinical data, and personal and family history. To determine overcrowding conditions, the width and length of the cells were measured and number of prisoners in each cell was determined.

Results: We evaluated 2103 prisoners, and identified 961 with lower respiratory symptoms (92.5% were men). Among them, 47 were diagnosed with Tb, 12 (25.5%) were detected only by culture. The annual incidence was 494 cases/100000 prisoners (Medellin: 515/100000; Bucaramanga: 443/100000). The median age was 30 years, 25.5% (12) had less than 15 days of cough, 12.7% had past history of TB and 44.6% (21) had prior contact with a Tb patient, 13 of the contacts were prisoners. TB-HIV co-infection was diagnosed in two cases, and we found two cases resistant to streptomycin and one to isoniazid. The median of square meters per person was 1.84 (IQR= 0.96-3.56).

Conclusion: TB in jails was very high in our study, about 20 times higher than in general population in Colombia that is 25 cases/100000 inhabitants. This illness should be considered in inmate patients with lower respiratory symptoms of any duration confined in those places and perform mycobacterial culture.

http://dx.doi.org/10.1016/j.ijid.2012.05.966

http://dx.doi.org/10.1016/j.ijid.2012.05.965