final program.qxd - Parallels Plesk Panel

PP 3.7
Functional limitation of Mycobacterium ulcerans cutaneous infections (Buruli
ulcer): usefulness of a functional limitation score
Rapp C,Ficko C, Imbert P, Barruet R, Debord T
Department of infectious and tropical diseases Military Hospital Bégin 69 avenue de Paris,
94163 Saint-Mandé, France
Buruli ulcer disease, caused by Mycobacterium ulcerans, is emerging in West Africa. Their
low case fatality rate is contrasting with the significant morbidity and the growing
ocio-economic impact of the osteoarticular sequelae.
Objective
To describe and quantify the functional sequelae of M ulcerans cutaneous infections in
Ivory Coast.
Patients and methods: All children over 2 years old and adults presenting with a Buruli
ulcer (BU) and treated since 2003 for more than 3 months were included in a 3 month
period. The functional damage was evaluated with a simplified quantitative score (a
questionnaire of 15 items adapted to daily life activities) inspired from the Buruli ulcer
functional score validated in Ghana by Stienstra an al (Am J Trop Med Hyg 2004).
Results
186 patients (96 males, 90 females) with a mean age of 16.5 years (3-72) were included.
The distribution of the 230 observed lesions was: upper limbs (42%), lower limbs (52%),
trunk and face (6%). The sequelae rate was 36.6% (n=68) with a mean functional
handicap score of 18.6% (0-80). The amputation rate was 4%. The worst affected were
children (23.4 vs 13.3%).The functional incapability of the patients resulted in 30% of the
children being taken out of the school system and 40% of the adults losing their job.
Comments
Our results confirm the significance of sequelae and their impact on precarious and rural
populations. The quantitative functional score is a simple and reliable tool. Its distribution
in health care centers should allow the measuring of individual benefit of physiotherapy.
On the community level, it can be used to evaluate necessary resources and to compare
the effectiveness of the therapeutic interventions. The search for sequelae risk factors and
appropriate management are urgent.
POSTERS
“ Focusing FIRST on PEOPLE “ 147 w w w . i s h e i d . c o m