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Volume 21, Number 8—August 2015
Dispatch

Seasonal Patterns of Buruli Ulcer Incidence, Central Africa, 2002–2012

Jordi LandierComments to Author , Guillaume Constantin de Magny, Andres Garchitorena, Jean-François Guégan, Jean Gaudart, Laurent Marsollier, Philippe Le Gall, Tamara Giles-Vernick, Sara Eyangoh, Arnaud Fontanet, and Gaëtan Texier
Author affiliations: Institut Pasteur, Paris, France (J. Landier, T. Giles-Vernick, A. Fontanet); Centre Pasteur du Cameroun, Réseau International des Instituts Pasteur, Yaoundé, Cameroon (J. Landier, S. Eyangoh, G. Texier); UMR MIVEGEC, Montpellier, France (G. Constantin de Magny, A. Garchitorena, J.-F. Guégan); Ecole des Hautes Etudes en Santé Publique, Rennes, France (A. Garchitorena, J.-F. Guégan); UMR912-SESSTIM, Marseille, France (J. Gaudart, G. Texier); INSERM and CHU et Université d’Angers, Angers, France (L. Marsollier); Institut de Recherche pour le Développement, Gif sur Yvette, France (P. Le Gall); Université Paris-Sud 11, Orsay, France. (P. Le Gall); Chaire Santé et Développement, Conservatoire National des Arts et Métiers, Paris (A. Fontanet)

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Figure 2

Schematic representation of the seasonal changes and possible links between the environment, Mycobacterium ulcerans presence, human exposure, and Buruli ulcer (BU) incidence in the Akonolinga district and the Nyong River valley, Cameroon, 2002–2012. For better visualization of delays, 18 months are shown. A) Average monthly rainfall and mean Nyong River flow (Technical Appendix). S., short. B) M. ulcerans in the aquatic environment (percentage of M. ulcerans–positive samples) (14). C) Estimated

Figure 2. Schematic representation of the seasonal changes and possible links between the environment, Mycobacterium ulcerans presence, human exposure, and Buruli ulcer (BU) incidence in the Akonolinga district and the Nyong River valley, Cameroon, 2002–2012. For better visualization of delays, 18 months are shown. A) Average monthly rainfall and mean Nyong River flow (Technical Appendix). S, dry, short dry season. B) M. ulcerans prevalencein the aquatic environment (percentage of M. ulcerans–positive samples) (14). C) Estimated abundance of M. ulcerans–positive hemipterans (expressed as % of maximum abundance) (14). D) Monthly median number of BU cases detected in the Akonolinga district, 2002–2012 (this study). E) Selected activities involving contacts with environments in which risk for BU is high (T. Giles-Vernick, pers. comm., 2015).

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