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Biomedical subjects

Claude Zinsou

Publications and source records attributed to Claude Zinsou.

9 recordsLinked to original sources

Risk factors for Buruli ulcer, Benin.

We identified risk factors for Buruli ulcer (BU) in Benin in an unmatched case-control study at the Centre Sanitaire et Nutritionnel Gbemoten in southern Benin. A total of 2,399 persons admitted from 1997 through 2003 and 1,444 unmatched patients with other conditions in 2002 were recruited. Adjusted odds ratios were determined for age, sex, place of residence, Mycobacterium bovis BCG vaccination at birth, type of water for domestic use, and occupation. Children <15 years of age and adults >49 years of age had a higher risk for BU. Use of unprotected water from swamps was associated with increased risk for BU; this association was strongest in adults >49 years of age. Sex was not a risk factor for BU. Our data showed that BU was mainly associated with age, place of residence, and water sources in all age groups. Risk for BU was higher in BCG-vaccinated patients > or =5 years of age.

Adolescent↗

BCG vaccine effectiveness against Buruli ulcer: a case-control study in Benin.

BCG remains the only possible prophylactic intervention against Buruli ulcer (BU). Estimating its public health impact on BU control is an important issue. We conducted a case-control study to investigate the vaccine effectiveness of routine BCG vaccine against BU in southern Benin. From August 2002 to August 2003, BCG vaccination status was obtained for 279 clinically diagnosed BU cases and 988 age- and sex-matched neighborhood controls. BCG coverage, which was estimated by the presence of a scar or a vaccination record, was 64.5% in cases and 67.2% in controls. There was no evidence of a protective effect of routine BCG vaccination against BU in southern Benin (vaccine effectiveness adjusted for socioeconomic status = 12%, 95% confidence interval = -24% to 37%).

Adolescent↗

Factors associated with functional limitations and subsequent employment or schooling in Buruli ulcer patients.

OBJECTIVES: To evaluate former Buruli ulcer disease (BUD) patients to assess the factors associated with functional limitations and subsequent employment or schooling. METHODS: The previously validated Buruli ulcer functional limitation score (BUFLS) questionnaire and interviews about educational and professional consequences incurred by BUD. RESULTS: Of 638 participants, 362 (57%) had a functional limitation after a median period of almost 4 years after treatment for BUD. A lesion on a joint, older age, female gender, a lesion on a distal part of an extremity and a persistent wound were found to be independent risk factors for stopping work or education. The same risk factors applied to the development of a functional limitation. Both functional limitations and financial difficulties due to BUD disease often led to job loss and school dropout. CONCLUSIONS: Rehabilitation programmes are urgently needed to diminish the suffering from the functional limitations and employment or schooling problems caused by BUD.

Adolescent↗

Buruli ulcer recurrence, Benin.

Buruli ulcer is a recognized public health problem in West Africa. In Benin, from 1989 to 2001, the Centre Sanitaire et Nutritionnel Gbemoten (CSNG) treated >2,500 Buruli ulcer patients. From March 2000 to February 2001, field trips were conducted in the Zou and Atlantique regions. The choice of the 2 regions was based on the distance from CSNG and on villages with the highest number of patients treated at CSNG. A total of 66 (44.0%) of 150 former patients treated at CSNG were located in the visited villages. The recurrence rate of CSNG-treated patients after a follow-up period of up to 7 years was low (6.1%, 95% confidence interval [CI] 2.0-15.6). We attribute this low rate to the high quality of Buruli ulcer treatment at an accessible regional center (CSNG). The World Health Organization definition of a Buruli ulcer recurrent case should be revised to include a follow-up period >1 year.

Anti-Bacterial Agents↗

Reliability and validity of the Buruli ulcer functional limitation score questionnaire.

The reliability and validity of the earlier developed Buruli ulcer functional limitation score (BUFLS) questionnaire was assessed. Of 638 former Buruli ulcer patients (of 678 individuals examined), sufficient items on daily activities (>or= 13 of the 19) were applicable to calculate a score. To determine the validity, the functional limitation scores of the 638 individuals were compared with the global impression of the limitations, range of motion (ROM), and the social impact (change of occupation or education) of Buruli ulcer. To determine inter-observer reliability, the functional limitation score was reassessed in 107 participants within one and three weeks after the first interview by another interviewer and interpreter. Both global impression and ROM correlated well with the functional limitation scores (rho = 0.66 and rho = 0.61). The inter-observer reliability of 107 participants as measured by an intra-class correlation coefficient of 0.86 was very good. The functional limitation scores measured in the second assessment were significantly higher than in the first assessment. This should be taken into account when the functional limitation score is used for the individual patient. The BUFLS can be used as for between group comparisons of endpoints in clinical trials and in the planning of resources.

Humans↗

Mycobacterium ulcerans disease (Buruli ulcer) in rural hospital, Southern Benin, 1997-2001.

Data from 1,700 patients living in southern Benin were collected at the Centre Sanitaire et Nutritionnel Gbemoten, Zagnanado, Benin, from 1997 through 2001. In the Zou region in 1999, Buruli ulcer (BU) had a higher detection rate (21.5/100,000) than leprosy (13.4/100,000) and tuberculosis (20.0/100,000). More than 13% of the patients had osteomyelitis. Delay in seeking treatment declined from 4 months in 1989 to 1 month in 2001, and median hospitalization time decreased from 9 months in 1989 to 1 month in 2001. This reduction is attributed, in part, to implementing an international cooperation program, creating a national BU program, and making advances in patient care.

Benin↗

First case of Mycobacterium ulcerans disease (Buruli ulcer) following a human bite.

Mycobacterium ulcerans disease (MUD) is rapidly reemerging in many countries, especially in West African countries. Antecedent trauma has often been related to the lesions that characterize this frequently crippling disease. We report here the first case of MUD that followed a human bite at the site where the lesion later occurred.

Adolescent↗

Psychosocial aspects of health seeking behaviours of patients with Buruli ulcer in southern Benin.

We investigated cultural beliefs and psychosocial factors associated with Buruli ulcer in southern Benin in order to elaborate and deliver appropriate health education messages. We conducted a qualitative study among 130 adults and 30 children in Zou province, a highly endemic region. Focus group interviews of inhabitants, patients and their assistants, health care professionals and traditional healers took place in Dasso, Ouinhi, Sagon and Zagnanado. Drawing sessions followed by individual interviews were organized among school children in Dasso and Sagon. We found that although Buruli ulcer is well known and recognized - even at a very early stage of the disease - and perceived as threatening, most people are reluctant to seek treatment at the health care centre. They are unclear about the origin of the disease (environmental factors or sorcery) and treatment is considered devastating, expensive and ineffective in some cases.

Adolescent↗