Abstract
BackgroundCameroon is endemic for Buruli ulcer (BU) and organised institutional BU control began in 2002. The objective was to describe the evolution, achievements and challenges of the national BU control programme (NBUCP) and to make suggestions for scaling up the programme.MethodsWe analysed collated data on BU from 2001 to 2014 and reviewed activity reports NBUCP in Cameroon. Case-detection rates and key BU control indicators were calculated and plotted on a time scale to determine trends in performance. A linear regression analysis of BU detection rate from 2005–2014 was done. The regression coefficient was tested statistically for the significance in variation of BU detection rate.Principal findingsIn 14 years of BU control, 3700 cases were notified. The BU detection rate dropped significantly from 3.89 to 1.45 per 100 000 inhabitants. The number of BU endemic health districts rose from two to 64. Five BU diagnostic and treatment centres are functional and two more are planned for 2015. The health system has been strengthened and BU research and education has gained more interest in Cameroon.Conclusion/SignificanceAlthough institutional BU control Cameroon only began 30 years after the first cases were reported in 1969, a number of milestones have been attained. These would serve as stepping stones for charting the way forward and improving upon control activities in the country if the major challenge of resource allocation is dealt with.
Highlights
Buruli ulcer (BU), caused by Mycobacterium ulcerans, is the third most common mycobacterial infection, after tuberculosis and leprosy
BU was first reported in Cameroon in 1969 [17], control activities only began effectively 33 years later, in 2002
The triggers for control activities in Cameroon were the new momentum to BU control following the 1998 Yamoussoukro Declaration [18] and the reconfirmation of the Nyong Basin in Central Cameroon as a BU endemic area by Noeske and colleagues in 2001, when they identified 436 clinical cases of BU, 162 of whom were sampled and 135 confirmed by IS2404 polymerase chain reaction (PCR) [19]
Summary
Buruli ulcer (BU), caused by Mycobacterium ulcerans, is the third most common mycobacterial infection, after tuberculosis and leprosy. M. ulcerans infection leads to chronic necrotizing ulcers [1], resulting in deformities, functional limitation and social stigma, if left untreated [2; 3]. The mode of transmission is unclear, some studies have suggested the involvement of an animal reservoir or of insect vectors [6]. All body parts may be involved, about 90% of lesions occur on the limbs [7], which may reflect the mode of transmission. Since M. ulcerans is thermosensitive, it is primarily causing skin lesions. Cameroon is endemic for Buruli ulcer (BU) and organised institutional BU control began in 2002. The objective was to describe the evolution, achievements and challenges of the national BU control programme (NBUCP) and to make suggestions for scaling up the programme
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