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Buruli Ulcer Prevalence and Altitude, Benin

2010; Centers for Disease Control and Prevention; Volume: 17; Issue: 1 Linguagem: Inglês

10.3201/eid1701.100644

1080-6059

Ghislain Emmanuel Sopoh, Roch Christian Johnson, Séverin Anagonou, Yves Thierry Barogui, Ange Dodji Dossou, Jean Gabin Houézo, Delphin Mavingha Phanzu, Brice Hughes Tente, Wayne M. Meyers, Françoise Portaels,

Actinomycetales infections and treatment

Buruli Ulcer Prevalence and Altitude, BeninTo the Editor: Buruli ulcer (BU), caused by Mycobacterium ulcerans, is one of 13 recently classifi ed neglected tropical diseases (1).Little is known about factors infl uencing its focal distribution.In Benin, altitude may play a role in such distribution of BU.Incidence, prevalence, and other health-related data are usually reported at national or district levels.These data convey the importance of the disease but do not show the wide variations existing at the village level.Data from the surveillance system (2) and surveys (3-6) in Benin have shown that BU-endemic areas are confi ned to the southern regions.Substantial variability in endemicity levels have been detected from 1 department to another, at the district and village levels, and from year to year (2-5).However, some districts (Lalo in the Mono-Couffo Department, Ouinhi in the Zou Department; Zê in the Atlantique Department; and Adjohoun, Bonou, and Dangbo in the Oueme Department) remain the most persistently BU-endemic from year to year.In addition, these BU-endemic districts are all located at the same latitude.A map of these districts can be superimposed on the Lama depression (a median band, oriented from west to east, that forms a large area at a low elevation, 130 km long with a width from 5 km in the area of Tchi in Lalo to 25 km in the area of Issaba in Pobê) (7).This factor prompted us to investigate whether variations in altitude correlate with BU prevalence.Using a Garmin eTrex global positioning system (Olathe, KS, USA), we collected precise geographic coordinates, including altitude, for each village in 2 persistently BU-endemic districts of the Atlantique Department.We chose districts where BU endemicity was high (Zê) and low (Toffo) (prevalences 52.0 and 7.8/10,000 inhabitants,