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首页> 外文期刊>PLOS Neglected Tropical Diseases >Geographic Distribution, Age Pattern and Sites of Lesions in a Cohort of Buruli Ulcer Patients from the Mapé Basin of Cameroon
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Geographic Distribution, Age Pattern and Sites of Lesions in a Cohort of Buruli Ulcer Patients from the Mapé Basin of Cameroon

机译：喀麦隆马佩盆地一群布鲁里溃疡患者的地理分布，年龄模式和病变部位

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Buruli ulcer (BU), a neglected tropical disease of the skin, caused by Mycobacterium ulcerans, occurs most frequently in children in West Africa. Risk factors for BU include proximity to slow flowing water, poor wound care and not wearing protective clothing. Man-made alterations of the environment have been suggested to lead to increased BU incidence. M. ulcerans DNA has been detected in the environment, water bugs and recently also in mosquitoes. Despite these findings, the mode of transmission of BU remains poorly understood and both transmission by insects or direct inoculation from contaminated environment have been suggested. Here, we investigated the BU epidemiology in the Mapé basin of Cameroon where the damming of the Mapé River since 1988 is believed to have increased the incidence of BU. Through a house-by-house survey in spring 2010, which also examined the local population for leprosy and yaws, and continued surveillance thereafter, we identified, till June 2012, altogether 88 RT-PCR positive cases of BU. We found that the age adjusted cumulative incidence of BU was highest in young teenagers and in individuals above the age of 50 and that very young children (<5) were underrepresented among cases. BU lesions clustered around the ankles and at the back of the elbows. This pattern neither matches any of the published mosquito biting site patterns, nor the published distribution of small skin injuries in children, where lesions on the knees are much more frequent. The option of multiple modes of transmission should thus be considered. Analyzing the geographic distribution of cases in the Mapé Dam area revealed a closer association with the Mbam River than with the artificial lake.
机译：由溃疡分枝杆菌引起的布鲁里溃疡（BU）是一种被忽视的热带皮肤病，在西非儿童中最常见。 BU的危险因素包括接近缓慢流动的水，差的伤口护理以及未穿防护服。已建议人为改变环境导致BU发生率增加。在环境，水虫中和最近在蚊子中都发现了溃疡分枝杆菌DNA。尽管有这些发现，BU的传播方式仍然知之甚少，并且已经提出了昆虫传播或从受污染环境直接接种的建议。在这里，我们调查了喀麦隆Mapé盆地的BU流行病学，据信，该地区自1988年以来的Mapé河大坝增加了BU的发病率。通过2010年春季的逐户调查，该调查还检查了当地的麻风和偏航人群，并在此后继续进行监视，直到2012年6月，我们共确定了88例RT-PCR阳性BU病例。我们发现，年龄调整后的BU累积发生率在青少年和50岁以上的个体中最高，而非常小的孩子（<5）的代表性不足。 BU病灶聚集在脚踝周围和肘部后部。这种模式既不符合已发表的任何蚊子叮咬位点模式，也不符合已发布的儿童小皮肤损伤分布，儿童膝部病变更为频繁。因此，应考虑多种传输方式的选择。分析MapéDam地区病例的地理分布，发现与姆巴姆河的联系比与人工湖的联系更紧密。

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