Ampah Kobina Assan, Asare Prince, Binnah Daniel De-Graft, Maccaulley Samuel, Opare William, Röltgen Katharina, Pluschke Gerd, Yeboah-Manu Dorothy
Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
Swiss Tropical and Public Health Institute, Molecular Immunology, Basel, Switzerland.
PLoS Negl Trop Dis. 2016 Apr 14;10(4):e0004603. doi: 10.1371/journal.pntd.0004603. eCollection 2016 Apr.
Buruli ulcer (BU) is a neglected tropical skin disease caused by Mycobacterium ulcerans with more than two thirds of the global cases reported in West Africa. A nationwide active BU case search conducted in 1999 identified two health districts along the Offin River as two of the three most endemic districts in Ghana. Based on recent anecdotal accounts that transmission is unstable along the Offin River, we conducted from March to June 2013 an exhaustive household survey and active case search in 13 selected communities within a five-kilometer radius along the Offin River. The overall prevalence of BU was 2.3% among the surveyed population of 20,390 inhabitants and 477 of the total 480 cases detected (99.4%) were historical (healed) cases. By estimating the year of occurrence for each case per community and taking into account available passive surveillance records of health facilities and the District Health Directorate, we observed a general trend of continuous emergence of cases in communities located midstream the Offin River whereas downstream communities showed more sporadic patterns. We monitored the incidence of cases after the survey and recorded a cumulative incidence rate of 0.04% for the 13 communities over a 17-month active surveillance period from August 2013 to December 2014. Our data reveal an overall decline in BU incidence along the Offin River similar to the general decline in BU incidence in recent years reported by the World Health Organization for West Africa.
布氏杆菌溃疡（BU）是一种由溃疡分枝杆菌引起的被忽视的热带皮肤病，全球超过三分之二的病例报告来自西非。1999年在全国范围内开展的布氏杆菌溃疡主动病例搜索发现，奥芬河沿岸的两个卫生区是加纳三个最流行的地区中的两个。基于最近的传闻称奥芬河沿岸的传播不稳定，我们于2013年3月至6月在奥芬河沿岸半径5公里范围内的13个选定社区进行了详尽的家庭调查和主动病例搜索。在接受调查的20390名居民中，布氏杆菌溃疡的总体患病率为2.3%，在检测出的480例病例中，有477例（99.4%）为既往（已治愈）病例。通过估计每个社区每例病例的发病年份，并考虑到卫生设施和地区卫生局现有的被动监测记录，我们观察到奥芬河中游社区病例持续出现的总体趋势，而下游社区的病例模式则更为零散。我们在调查后监测了病例的发病率，并记录了从2013年8月至2014年12月的17个月主动监测期内，13个社区的累积发病率为0.04%。我们的数据显示，奥芬河沿岸布氏杆菌溃疡的发病率总体呈下降趋势，这与世界卫生组织报告的近年来西非布氏杆菌溃疡发病率的总体下降趋势相似。
