Prevalence of Buruli Ulcer in Akonolinga Health District, Cameroon Results of a Cross Sectional Survey 英文参考文献.docVIP

PrevalenceofBuruliUlcerinAkonolingaHealthDistrict, Cameroon:ResultsofaCrossSectionalSurvey KlaudiaPorten1*,KarenSailor2,EricComte2,AdelaideNjikap2,AgnesSobry2,FrancoisSihom3 ,Abanda Meva’a3,SarahEyangoh4,MarkMyatt5,FabienneNackers1,RebeccaF.Grais1 1Epicentre,Paris,France,2Me′decinsSansFrontie`res,Geneva,Switzerland,3DistrictdeSante′Akonolinga,Akonolinga,Cameroon,4CentrePasteur,Yaounde′,Cameroon, 5DivisionofEpidemiology,InstituteofOphthalmology,UniversityCollegeLondon,London,UnitedKingdom Abstract Background: Buruli ulcer (BU) is a chronic, indolent necrotizing disease of the skin and underlying tissues caused by Mycobacteriumulcerans,whichmayresultinfunctionalincapacity.In2002,Me′decins SansFrontie`res(MSF)openedaBU programmeinAkonolingaHospital,Cameroon,offeringantibiotictreatment,surgeryandgeneralmedicalcare.Sixhundred patients have been treated in the project to date. However, due to the nature of the disease and its stigmatization, determiningtheexactprevalenceandburdenofdiseaseisdifficultandcurrentestimatesmaynotreflectthemagnitudeof the problem. The objectives of this survey were to estimate the prevalence of BU in the health district of Akonolinga, describe thegeographic extensionof the highlyendemic area within the healthdistrict, anddetermine the programme coverageanditsgeographicaldistribution. Methodology/PrincipalFindings:Weconductedacross-sectionalpopulationsurveyusingcentricsystematicareasampling (CSAS).A15615kmgrid(quadratsof225km2)wasoverlaidonamapofAkonolingadistrictwithitspositionchosento maximizetheareacoveredbythesurvey.Quadratswereselectedifmorethan50%ofthequadratwasinsideofthehealth district.ThechiefdomlocatedclosesttothecentreofeachquadratwasselectedandBurulicaseswereidentifiedusingan activecasefindingstrategy(thesensitivityofthestrategywasestimatedbycapture-recapture).WHO-casedefinitionswere used for nodules, plaque, ulcer, oedema and sequelae. Out of a total population of 103,000 inhabitants, 26,679 were surveyedwithinthetwentyquadrat