{"id":4029,"date":"2023-01-30T18:00:48","date_gmt":"2023-01-30T18:00:48","guid":{"rendered":"https:\/\/afiyafrica.com\/?p=4029"},"modified":"2023-01-31T10:17:54","modified_gmt":"2023-01-31T10:17:54","slug":"oms-temoignage-en-republique-democratique-du-congo-un-hopital-traque-lulcere-de-buruli","status":"publish","type":"post","link":"https:\/\/afiyafrica.com\/index.php\/dossier\/oms-temoignage-en-republique-democratique-du-congo-un-hopital-traque-lulcere-de-buruli\/","title":{"rendered":"OMS : T\u00e9moignage : En R\u00e9publique d\u00e9mocratique du Congo, un h\u00f4pital traque l\u2019ulc\u00e8re de Buruli"},"content":{"rendered":"
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\n \t<\/i> Read Time:<\/span>5 Minute, 30 Second <\/div>\n\n <\/div>\n

Dans son petit atelier de cordonnerie \u00e0 Kimpese, un village situ\u00e9 \u00e0 220 km au sud-ouest de Kinshasa, Martin*, 36 ans, se souvient comme si c\u2019\u00e9tait hier de cette plaque indolore qui est apparue sur sa jambe droite, il y a 18 ans. C\u2019\u00e9tait le d\u00e9but d\u2019un p\u00e9riple qui a compl\u00e8tement boulevers\u00e9 sa vie et lui a laiss\u00e9 une marque \u00e0 vie. \u00c0 l\u2019\u00e9poque, le jeune adolescent ne se doutait pas que cette petite plaque sur la peau pourrait le rendre handicap\u00e9.<\/p>\n\n\n\n

\u00ab Au d\u00e9part, mes parents et moi, nous ne nous sommes pas inqui\u00e9t\u00e9s car je ne ressentais rien de grave. Nous pensions m\u00eame que cette plaque allait dispara\u00eetre aussi vite qu\u2019elle \u00e9tait apparue \u00bb, se rem\u00e9more-t-il. Mais, son \u00e9tat s\u2019\u00e9tait d\u00e9grad\u00e9 et les premiers traitements administr\u00e9s dans un centre de sant\u00e9 de sa localit\u00e9 n\u2019ont eu aucun effet. \u00ab La plaque a envahi toute ma jambe et la maladie s\u2019est attaqu\u00e9e \u00e0 ma peau et \u00e0 mes os \u00bb, ajoute Martin. \u00ab \u00c7a devenait de plus en plus insupportable et de nombreuses personnes dans mon entourage pensaient qu\u2019on m\u2019avait jet\u00e9 un sort. Et j\u2019y croyais aussi. \u00bb <\/p>\n\n\n\n

Martin \u00e9tait victime d\u2019un ulc\u00e8re de Buruli. En langue kikongo en R\u00e9publique d\u00e9mocratique du Congo, cette affection est appel\u00e9e \u00ab mbasu \u00bb, ce qui signifie \u00ab mauvais sort \u00bb. <\/p>\n\n\n\n

L\u2019ulc\u00e8re de Buruli est la troisi\u00e8me mycobact\u00e9riose touchant l’homme, apr\u00e8s la l\u00e8pre et la tuberculose, et se manifeste souvent d\u2019abord par un nodule indolore avant que n\u2019apparaisse une plaque ou un \u0153d\u00e8me diffus et indolore sur les jambes, les bras ou le visage. La maladie peut progresser sans douleur ou fi\u00e8vre, mais en l\u2019absence de traitement, ou parfois au cours de l\u2019antibioth\u00e9rapie, le nodule, la plaque ou l\u2019\u0153d\u00e8me s\u2019ulc\u00e8re en quatre semaines. Il arrive que l\u2019os soit touch\u00e9, ce qui entra\u00eene des d\u00e9formations.<\/p>\n\n\n\n

Cette maladie tropicale n\u00e9glig\u00e9e est end\u00e9mique en R\u00e9publique d\u00e9mocratique du Congo, notamment dans le Kongo central, le Maniema, le Ma\u00ef-Ndombe, le Kwilu et le Kwango, avec en moyenne 50 cas enregistr\u00e9s chaque ann\u00e9e.\u00a0<\/p>\n\n\n\n

L\u2019H\u00f4pital g\u00e9n\u00e9ral de r\u00e9f\u00e9rence (HGR) de l\u2019Institut m\u00e9dical \u00e9vang\u00e9lique (IME) de Kimpese est connu pour \u00eatre le seul du pays d\u00e9di\u00e9 uniquement \u00e0 la prise charge des cas d\u2019ulc\u00e8re de Buruli, depuis sa mise en place en 1999. \u00ab Notre but est de contribuer \u00e0 la r\u00e9duction de la morbidit\u00e9 et des incapacit\u00e9s li\u00e9es \u00e0 cette maladie \u00bb, rappelle le Dr Delphin Phanzu, m\u00e9decin et coordonnateur du Projet de lutte contre l\u2019ulc\u00e8re de Buruli.<\/p>\n\n\n\n

C\u2019est lors du passage d\u2018une \u00e9quipe du projet dans son village que Martin a pu \u00eatre proprement diagnostiqu\u00e9, apr\u00e8s cinq ans d\u2019errance m\u00e9dicale. Lui et sa famille n\u2019avait jamais entendu parl\u00e9 de l\u2019ulc\u00e8re de Buruli auparavant.<\/p>\n\n\n\n

\u00ab La lutte contre cette maladie invalidante a beaucoup \u00e9volu\u00e9 \u00bb, rassure le Dr Th\u00e9ophile Luza\u00efsu, Directeur G\u00e9n\u00e9ral de l\u2019h\u00f4pital. \u00ab Pendant des ann\u00e9es, nous avons mis un accent particulier sur la formation du personnel, le pr\u00e9l\u00e8vement en communaut\u00e9, la sensibilisation des populations et l\u2019am\u00e9lioration continue de la prise en charge \u00bb, souligne-t-il.<\/p>\n\n\n\n



Le nombre de cas, venant des diff\u00e9rentes zones end\u00e9miques du pays, admis en hospitalisation dans cet h\u00f4pital a consid\u00e9rablement baiss\u00e9, passant de plus de 64 cas dans les ann\u00e9es 2000 \u00e0 2010 \u00e0 seulement 5 cas r\u00e9pertori\u00e9s en 2022. Par ailleurs, le pr\u00e9l\u00e8vement en communaut\u00e9 a permis de d\u00e9tecter la maladie pr\u00e9cocement : au d\u00e9but des ann\u00e9es 2000, 95 % des malades admis l\u2019\u00e9taient au stade le plus avanc\u00e9 de la maladie avec une dur\u00e9e moyenne d\u2019hospitalisation de 89 jours. \u00ab Aujourd\u2019hui la dur\u00e9e moyenne d\u2019hospitalisation est de moins de 60 jours \u00bb, se r\u00e9jouit Dr Luza\u00efsu. \u00ab Les patients arrivent maintenant tr\u00e8s t\u00f4t dans notre structure. \u00bb

Le traitement recommand\u00e9 actuellement consiste en une association d\u2019antibiotiques coupl\u00e9e \u00e0 de soins compl\u00e9mentaires dans les cas d\u2019ulc\u00e9ration. Des recherches en cours explorent prioritairement des pistes permettant de raccourcir la dur\u00e9e du traitement \u00e0 8 semaines.

Face au poids des fausses croyances et des pr\u00e9jug\u00e9s li\u00e9s \u00e0 l\u2019ulc\u00e8re de Buruli, la prise en charge m\u00e9dicale est soutenue par un accompagnement psychosocial. L\u2019infirmi\u00e8re Lucie Lutiaku travaille dans ce centre depuis 2014 et a \u00e9t\u00e9 plusieurs fois form\u00e9e, avec l\u2019appui de l\u2019Organisation mondiale de la Sant\u00e9 (OMS) et de ses partenaires tels que American Leprosy Missions (ALM). \u00ab Toutes ces formations et directives sur le traitement et la prise en charge de l\u2019ulc\u00e8re de Buruli expliquent ces r\u00e9sultats positifs \u00bb, affirme-t-elle. \u00ab Lorsque nous recevons des cas \u00e0 l\u2019h\u00f4pital, en plus des soins, notre r\u00f4le est aussi de rassurer le malade et l\u2019aider \u00e0 reprendre confiance. Nous mettons aussi \u00e0 contribution les proches des malades pour les soutenir et les encourager tout au long du processus de traitement. \u00bb\u00a0

L\u2019H\u00f4pital g\u00e9n\u00e9ral de r\u00e9f\u00e9rence contre l\u2019ulc\u00e8re de Buruli de Kimpese s\u2019illustre aussi dans la pr\u00e9vention. Il a d\u00e9velopp\u00e9 des outils de sensibilisation \u00e0 l\u2019instar des bo\u00eetes \u00e0 images. Des \u00e9missions radio-t\u00e9l\u00e9vis\u00e9es, des dialogues communautaires et des campagnes de sensibilisation sont r\u00e9guli\u00e8rement organis\u00e9s afin d\u2019\u00e9duquer la population au d\u00e9pistage pr\u00e9coce gage d\u2019une victoire sur la maladie. D\u00e8s l\u2019apparition des premiers sympt\u00f4mes, notamment un nodule, une plaque ou un \u0153d\u00e8me indolore des jambes, des bras ou du visage, le premier r\u00e9flexe recommand\u00e9 est de se rendre imm\u00e9diatement dans une structure sanitaire.\u00a0

Dans l\u2019accompagnement pour la d\u00e9tection rapide, l\u2019Institut national de recherche biom\u00e9dicale (IRNB) appuie les diff\u00e9rentes initiatives dans l\u2019analyse des \u00e9chantillons pr\u00e9lev\u00e9s en communaut\u00e9 dont les r\u00e9sultats sont disponibles sous 72 heures. Ainsi en 2022, plus de 288 \u00e9chantillons ont \u00e9t\u00e9 re\u00e7us et analys\u00e9s permettant ainsi de confirmer 75 cas positifs \u00e0 la PCR qui ont \u00e9t\u00e9 pris en charge aussit\u00f4t.\u00a0

L\u2019OMS appuie le pays dans cette lutte en mettant \u00e0 sa disposition des m\u00e9dicaments pour la prise en charge. \u00ab Depuis plusieurs ann\u00e9es, nous sommes aux cot\u00e9s de la RDC pour l\u2019\u00e9laboration et la mise en \u0153uvre des orientations cl\u00e9s afin d\u2019assurer aux patients une th\u00e9rapie appropri\u00e9e pour qu\u2019ils retrouvent un vie normale \u00bb, a d\u00e9clar\u00e9 le Dr Am\u00e9d\u00e9e Prosper Djiguimd\u00e9, Charg\u00e9 de bureau de l\u2019OMS en R\u00e9publique d\u00e9mocratique du Congo.\u00a0

Trait\u00e9 \u00e0 l\u2019H\u00f4pital g\u00e9n\u00e9ral de r\u00e9f\u00e9rence de Kimpese pour une l\u00e9sion ulc\u00e9r\u00e9e au membre inf\u00e9rieur droit, Martin est sorti gu\u00e9ri apr\u00e8s deux mois d\u2019hospitalisation, mais il se d\u00e9place d\u00e9sormais avec des b\u00e9quilles. Il a n\u00e9anmoins repris go\u00fbt \u00e0 la vie. \u00ab D\u00e9sormais, je passe le message autour de moi, car cela peut sauver des vies \u00bb.\u00a0 <\/p>\n\n\n\n

* Le nom a \u00e9t\u00e9 chang\u00e9

Organisation Mondiale de la Sant\u00e9 <\/p>\n

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