title: Burden of Mycobacterium ulcerans disease (Buruli ulcer) and the underreporting ratio in the territory of Songololo, Democratic Republic of Congo.
abstract: BACKGROUND
  Cutaneous infection by Mycobacterium ulcerans, also known as Buruli ulcer (BU), represents the third most common mycobacterial disease in the world after tuberculosis and leprosy. Data on the burden of BU disease in the Democratic Republic of Congo are scanty. This study aimed to estimate the prevalence rate and the distribution of BU in the Songololo Territory, and to assess the coverage of the existing hospital-based reporting system.
  
  
  METHODS
  We conducted a cross-sectional survey (July-August 2008) using the door-to-door method simultaneously in the two rural health zones (RHZ) of the Songololo Territory (RHZ of Kimpese and Nsona-Mpangu), each containing twenty health areas. Cases were defined clinically as active BU and inactive BU in accordance with WHO-case definitions.
  
  
  RESULTS
  We detected 775 BU patients (259 active and 516 inactive) in a total population of 237,418 inhabitants. The overall prevalence of BU in Songololo Territory was 3.3/1000 inhabitants, varying from 0 to 27.5/1000 between health areas. Of the 259 patients with active BU, 18 (7%) had been reported in the hospital-based reporting system at Kimpese in the 6-8 months prior to the survey.
  
  
  CONCLUSIONS
  The survey demonstrated a huge variation of prevalence between health areas in Songololo Territory and gross underreporting of BU cases in the hospital-based reporting system. Data obtained may contribute to better targeted and improved BU control interventions, and serve as a baseline for future assessments of the control program.
authors: General Reference Hospital of Kimpese, Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo ; Department of Public Health, Unit of Epidemiology and Disease Control, Institute of Tropical Medicine, Antwerp, Belgium.
authors: Delphin
authors: D
authors: Mavinga Phanzu
authors: Patrick
authors: P
authors: Suykerbuyk
authors: Paul
authors: P
authors: Saunderson
authors: Philippe
authors: P
authors: Ngwala Lukanu
authors: Jean-Bedel
authors: JB
authors: Masamba Minuku
authors: Désiré Bofunga B
authors: DB
authors: Imposo
authors: Blanchard
authors: B
authors: Mbadu Diengidi
authors: Makanzu
authors: M
authors: Kayinua
authors: Jean-Jacques
authors: JJ
authors: Tamfum Muyembe
authors: Pascal
authors: P
authors: Tshindele Lutumba
authors: Bouke C
authors: BC
authors: de Jong
authors: Françoise
authors: F
authors: Portaels
authors: Marleen
authors: M
authors: Boelaert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054312:Buruli Ulcer / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D018563:Disease Notification / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019911:Mycobacterium ulcerans / Q000302:isolation & purification*; D015995:Prevalence; D055815:Young Adult