title: [Buruli ulcer in the health districts of the Democratic Republic of Congo from 1950 to 2013: literature review and new distribution map].
abstract: This paper describes the current distribution of cases of Buruli ulcer (BU) by highlighting health districts that are endemic and suspected to be endemic, based on the studies, surveys, and activity reports published from 1950 to 2013. We define as endemic any health district with BU patients positive by PCR, whether or not positive on a Ziehl-Neelsen (ZN) test, culture or histologic sample. A district is defined as suspected to be endemic when it is a historical BU area, has BU clinical cases and/or patients with positive ZN, but negative PCR. Of the 515 health districts in the DRC, 17 were found to be endemic (3%) and 26 suspected to be endemic (5%). In most cases, former focal areas, described before 1974, remain currently active. New focal points were found along the Kwango River in the province of Bandundu. We also discovered the extension of former BU focal areas to neighboring health districts in the provinces of Bas-Congo, Bandundu, and Maniema. The need for diagnostic confirmation by PCR appears to be a requirement and a priority, not only in all former historical focal areas but also in the health districts newly suspected to be endemic.
authors.affiliation: Unité de chirurgie plastique reconstructive et esthétique, chirurgie de la main et brûlologie, cliniques universitaires de Kinshasa, université de Kinshasa, BP 834 Kinshasa XI, République démocratique du Congo.
authors.forename: K
authors.initials: K
authors.lastname: Kibadi
authors.affiliation: Maladies tropicales négligées, Bureau régional pour l'Afrique, Organisation mondiale de la santé, Brazzaville, République du Congo.
authors.forename: A
authors.initials: A
authors.lastname: Tiendrebeogo
authors.affiliation: Maladies tropicales négligées, Bureau régional pour l'Afrique, Organisation mondiale de la santé, Brazzaville, République du Congo.
authors.forename: B
authors.initials: B
authors.lastname: Ekoue Kinvi
authors.affiliation: Département des sciences biomédicales, Institut de médecine tropicale, Anvers, Belgique.
authors.forename: B
authors.initials: B
authors.lastname: De Jong
authors.affiliation: Département de santé publique, Institut de médecine tropicale, Anvers, Belgique.
authors.forename: M
authors.initials: M
authors.lastname: Boelaert
authors.affiliation: Département des sciences biomédicales, Institut de médecine tropicale, Anvers, Belgique.
authors.forename: F
authors.initials: F
authors.lastname: Portaels
mesh_terms: D054312:Buruli Ulcer / Q000453:epidemiology*; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D006801:Humans; D013997:Time Factors
keywords: Buruli ulcer; The Democratic Republic of the Congo; health zone; map; polymerase chain reaction (PCR)