Profil de l’ulcère de Buruli pris en charge au Centre national de référence du Togo: étude de 119 cas

B. Saka1, D. E. Landoh2, B. Kobara3,4, K. E. Djadou5, I. Yaya6, K. B. Yékplé1, E. Piten3, A. Balaka7, S. Akakpo1, K. Kombaté1, A. Mouhari-Toure1, K. Kanassoua8, P. Pitché1
1Service de dermatologie, CHU de Tokoin, université de Lomé, Lomé, Togo
2Division de l’épidémiologie, Ministère de la santé, Lomé, Togo
3Centre national de référence et de traitement de l’ulcère de Buruli, CHR de Tsévié, Tsévié, Togo
4Programme national de lutte contre l’ulcère de Buruli, lèpre et Pian, Lomé, Togo
5Service de pédiatrie, CHR de Tsévié, Tsévié, Togo
6Programme national de lutte contre la tuberculose, Lomé, Togo
7Service de médecine interne, CHU de Tokoin, université de Lomé, Lomé, Togo
8Service de chirurgie générale, CHR de Tsévié, Tsévié, Togo

Tóm tắt

The purpose of this study was to describe the epidemiological, clinical, therapeutic profile and the outcome of Buruli ulcer (BU) in the National Reference Center for Buruli ulcer treatment (NRCBUT) in Togo. It was a retrospective and descriptive study of records of patients treated for BU in the NRCBUT between June 2007 and December 2010. During the study period, 119 patients (56.3% males) were treated in the NRCBUT for BU. The median age of patients was 14 years. The proportion of children (< 15 years) was 56.3%. On admission, 85 patients were at ulcer stage and 34 patients at the pre-ulcer stage. BU wounds were mainly located on lower limbs (50.4%), followed by upper limbs (32.6%) and trunk (13.3%). The location of the wounds on the lower limbs were more frequent in patients older than 15 years (P < 0.001), while those on the upper limbs (P = 0.002) and trunk (P = 0.03) were more frequent in patients aged less than 15 years. All patients had received medical treatment which was based on rifampicin-streptomycin combination for eight weeks. This treatment was coupled to surgery in 30 cases. The outcome was punctuated by complications in 7 patients, limb amputation in 3 patients, and sequels in 10 patients. This study confirmed that the BU is the prerogative of young subjects and the exposed areas in the skin facilitates transmission. Apart from these classic features, some unique aspects including the age-dependent distribution are related to the pathogenesis of this disease.

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