[Buruli ulcer in Togo: a hospital study]

Buruli ulcer is an emerging disease with a high prevalence in many West African countries neighbouring Togo. The aim of the present study is to assess the situation in Togolese hospitals. It was conducted for 2 years (between January 2000 and December 2001) based on the Buruli ulcer record files set up in Togolese hospitals, with a view to analyse the incidence of the disease, its characteristics in the patients and its topographic distribution in relation to their environment. During this period, 180 patients were recorded, 120 of whom were male and 18 female. The average age was 20.7 years and 20.6% of the cases were children. Lower limbs were more affected (153), followed by upper limbs (20), trunk (5), head and neck (2). Large ulcerative lesions were recorded in 11.11% of cases (n = 20), localised in 7.5% of the patients (n = 143), diffuse or metastatic in 9.4% of cases. No pre-ulcerative lesion was found. An increase in the incidence of the disease was observed from one year to the other while cases were notified in new care centres. Three risk areas were identified according to the origin of the patients : the laguna area of the coast, marshy inland areas where market crops and rice are cultivated and river valley areas. The study revealed that Buruli ulcer cases treated in Togolese hospitals were increasing year after year. A morbidity study is necessary to assess the importance of the disease on a national scale.