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Free Content Association between haemoglobin variants S and C and Mycobacterium ulcerans disease (Buruli ulcer): a case-control study in Benin

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Summary Risk factors for Buruli ulcer (BU) are poorly understood. We conducted a case-control study in southern Benin to investigate the association between haemoglobin variants S or C and BU, and particularly the association between haemoglobinopathies HbSS/SC and BU osteomyelitis. We compared the haemoglobin genotype of 179 patients with BU and 44 with BU osteomyelitis to that of 242 community controls. We found no evidence of an increased risk of BU according to the presence of haemoglobin variants S and/or C [odds ratio adjusted for sex, age, region of residence and ethnicity: 1.24 (95%CI: 0.80–1.93),  = 0.34]. Haemoglobin variants S and C are unlikely to play a role in the BU burden. However, haemoglobinopathies HbSS/SC were more frequent among BU osteomyelitis patients than among controls (6.8% 1.0%, Fisher's exact -value = 0.045), which may suggest that those disorders facilitate growth of in the bone matrix.

Les facteurs de risque de l'ulcère de Buruli sont peu connus. Nous avons mené une étude cas-témoins dans le sud du Bénin pour investiguer l'association entre les variantes S et C de l'hémoglobine et l'ulcère de Buruli et, en particulier, l'association entre les hémoglobinopathies HbSS/SC et les ostéomyélites àM.ulcerans. Nous avons comparé le génotype de l'hémoglobine de 179 patients atteints d'ulcère de Buruli et de 44 patients avec une ostéomyélite àM.ulceransà celui de 242 témoins de la communauté. Nous n'avons trouvé aucune évidence d'un plus grand risque d'ulcère de Buruli en présence des variantes S et/ou C de l'hémoglobine (OR ajusté pour le sexe, l’âge, la région de résidence et l'appartenance ethnique : 1,24 [IC95% : 0,80–1,93], P = 0,34). Il est peu probable que les variantes S et C de l'hémoglobine jouent un rôle dans le fardeau de l'ulcère de Buruli. Cependant, les hémoglobinopathies HbSS/SC étaient plus fréquentes chez les patients avec une ostéomyélite àM.ulcerans que chez les témoins (6,8% contre 1,0%, P-valeur du test exact de Fisher = 0,045), ce qui permet de suggérer que ces troubles de l'hémoglobine pourraient faciliter la croissance de M.ulcerans dans le tissu osseux.
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Keywords: Benin; Bénin; Case-Control Studies; Estudios caso-control; Haemoglobin C; Haemoglobin S; Hemoglobina C; Hemoglobina S; Mycobacterium ulcerans; Osteomielitis; Osteomyelitis; hémoglobine C; hémoglobine S; ostéomyélite; Études cas-témoins

Document Type: Research Article

Affiliations: 1:  Epidemiology Unit, Université catholique de Louvain, Brussels, Belgium 2:  Laboratory of Applied Molecular Technology, Centre for Human Genetics, Université catholique de Louvain, Brussels, Belgium 3:  Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, United Kingdom 4:  Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium

Publication date: 01 April 2007

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