Adequate Wound Care and Use of Bed Nets as Protective Factors against Buruli Ulcer Results from a Case Control Study in Cameroon 英文参考文献.docVIP

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Adequate Wound Care and Use of Bed Nets as Protective Factors against Buruli Ulcer Results from a Case Control Study in Cameroon 英文参考文献.doc

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Adequate Wound Care and Use of Bed Nets as Protective Factors against Buruli Ulcer Results from a Case Control Study in Cameroon 英文参考文献

AdequateWoundCareandUseofBedNetsasProtective FactorsagainstBuruliUlcer:ResultsfromaCaseControl StudyinCameroon JordiLandier1,2,3,PascalBoisier2,Fe′lixFotsoPiam1,BlanbinNoumen-Djeunga4,JosephSime′4,Fide`le GaetanWantong4,LaurentMarsollier5,ArnaudFontanet3,6,SaraEyangoh1* 1Service de Mycobacte′riologie, Centre Pasteur du Cameroun, Re′seau International des Instituts Pasteur, Yaounde′, Cameroon, 2Service d’Epide′miologie et de Sante′ Publique, Centre Pasteur du Cameroun, Re′seau International des Instituts Pasteur, Yaounde′, Cameroon, 3Unite′ d’Epide′miologie des Maladies Emergentes, Institut Pasteur,Paris,France,4Ho?pitaldeDistrictdeBankim,Bankim,Adamaoua,Cameroon,5Grouped’EtudedesInteractionsHo?te-Pathoge`ne,Universite′ d’Angers,Angers, France,6ConservatoireNationaldesArtsetMe′tiers,ChaireSante′ etDe′veloppement,Paris,France Abstract Background: Buruli ulcer is an infectious disease involving the skin, caused by Mycobacterium ulcerans. Its exact transmission mechanism remains unknown. Several arguments indicate a possible role for insects in its transmission. A previouscase-controlstudyintheNyongvalleyregionincentralCameroonshowedanunexpectedassociationbetween bednetuseandprotectionagainstBuruliulcer.Weinvestigatedwhetherthisassociationpersistedinanewlydiscovered endemicBuruliulcerfocusinBankim,northwesternCameroon. Methodology/PrincipalFindings:Weconductedacase-controlstudyon77Buruliulcercasesand153age-,gender-and village-matched controls. Participants were interviewed about their activities and habits. Multivariate conditional logistic regressionanalysisidentifiedsystematicuseofabednet(Odds-Ratio(OR)=0.4,95%ConfidenceInterval[95%CI]=[0.2–0.9], p-value (p)=0.04), cleansing wounds with soap (OR [95%CI]=0.1 [0.03–0.3], p,0.0001) and growing cassava (OR [95%CI]=0.3 [0.2–0.7], p=0.005) as independent protective factors. Independent risk factors were bathing in the Mbam River (OR [95%CI]=6.9 [1.4–35], p=0.02) and reporting scratch lesions after insect bite