@article{fdi:010073858,
  title = {{M}ycobacterium ulcerans infection ({B}uruli ulcer) in {F}rench {G}uiana, {S}outh {A}merica, 1969–2013: an epidemiological study},
  author = {{D}ouine, {M}. and {G}ozlan, {R}odolphe and {N}acher, {M}. and {D}ufour, {J}. and {R}eynaud, {Y}. and {E}lguero, {E}ric and {C}ombe, {M}arine and {V}elvin, {C}. and {C}hevillon, {C}. and {B}erlioz-{A}rthaud, {A}. and {L}abb{\'e}, {S}. and {S}ainte-{M}arie, {D}. and {G}u{\'e}gan, {J}ean-{F}ran{\c{c}}ois and {P}radinaud, {R}. and {C}ouppi{\'e}, {R}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {M}ycobacterium ulcerans infection is the third most common mycobacterial disease in the world after tuberculosis and leprosy. {T}o date, transmission pathways from its environmental reservoir to humans are still unknown. {I}n {S}outh {A}merica, {F}rench {G}uiana has the highest reported number of {M} ulcerans infections across the continent. {T}his empirical study aimed to characterise the epidemiology of {M} ulcerans infection in {F}rench {G}uiana between 1969 and 2013. {M}ethods: {D}ata were collected prospectively mainly by two dermatologists at {C}ayenne {H}ospital's dermatology department between {J}an 1, 1969, and {D}ec 31, 2013, for age, date of diagnosis, sex, residence, location of the lesion, type of lesion, associated symptoms, and diagnostic method (smear, culture, {PCR}, or histology) for all confirmed and suspected cases of {M} ulcerans. {W}e obtained population data from censuses. {W}e calculated mean {M} ulcerans infection incidences, presented as the number of cases per 100 000 person-years. {F}indings: 245 patients with {M} ulcerans infections were reported at {C}ayenne {H}ospital's dermatology department during the study period. {M} ulcerans infection incidence decreased over time, from 6·07 infections per 100 000 person-years (95% {CI} 4·46–7·67) in 1969–83 to 4·77 infections per 100 000 person-years (3·75–5·79) in 1984–98 and to 3·49 infections per 100 000 person-years (2·83–4·16) in 1999–2013. {T}he proportion of children with infections also declined with time, from 42 (76%) of 55 patients in 1969–83 to 26 (31%) of 84 in 1984–98 and to 22 (21%) of 106 in 1999–2013. {M}ost cases occurred in coastal areas surrounded by marshy savannah (incidence of 21·08 per 100 000 person-years in {S}innamary and 21·18 per 100 000 person-years in {M}ana). {L}esions mainly affected limbs (lower limbs 161 [66%] patients; upper limbs 60 [24%] patients). {W}e diagnosed no bone infections. {I}nterpretation: {T}he decrease of {M} ulcerans infection incidence and the proportion of children with infections over a 45 year period in this ultra-peripheral {F}rench territory might have been mostly driven by improving living conditions, prophylactic recommendations, and access to health care.},
  keywords = {{INFECTION} ; {EPIDEMIOLOGIE} ; {ENQUETE} ; {ENFANT} ; {BACTERIE} ; {GENETIQUE} {DE} {POPULATION} ; {RESERVOIR} ; {ENVIRONNEMENT} ; {ULCERE} {DE} {BURULI} ; {GUYANE} {FRANCAISE}},
  booktitle = {},
  journal = {{L}ancet {P}lanetary {H}ealth},
  volume = {1},
  numero = {2},
  pages = {e65--e73},
  ISSN = {2542-5196},
  year = {2017},
  DOI = {10.1016/{S}2542-5196(17)30009-8},
  URL = {https://www.documentation.ird.fr/hor/fdi:010073858},
}