Leprosy - neglected tropical disease in Pygmies inhabiting Central African Republic.

Leprosy is a neglected tropical disease that is still present worldwide despite efforts aimed at elimination of the disease. The BaAka Pygmy community inhabiting rural areas in the Central African Republic is one of the most leprosy-vulnerable populations. The aim of the study was to assess the prevalence of leprosy in the BaAka Pygmy population. People living in the Dzanga Sangha protected area were regularly visited by a mobile clinic in 2019/2020. The diagnosis was based on the clinical manifestation of the disease. Deformations of skin and extremities were assessed. In a 12-month period 26 cases of leprosy were diagnosed and 25 patients received treatment. 24 of those patients were BaAka Pygmies, 10 were women, 7 were children under 15 years old and 8 were diagnosed with grade 2 disability. Presented data shows that leprosy in Dzanga Sangha region is not well controlled due to the high transmission rate. Efforts to diagnose and report new leprosy cases should be intensified.

Evidence of high endemicity of leprosy and yaws in the municipality of Balé-Loko in the Central African Republic.

The incidence of neglected tropical diseases (NTD) can serve as an indicator for assessing the quality of healthcare systems because these diseases affect the poorest populations, living in areas where healthcare access is most difficult. The Central African Republic Ministry of Health, in collaboration with FAIRMED, decided to conduct the survey reported here in a village named/owned by the Central African Society of Agriculture and Wood Peeling (SCAD). The study took place from June 11-20, 2017. There were 137 clinical diagnoses of yaws, 102 of them positive on laboratory tests. Moreover, 79% were highly contagious forms. The prevalence of yaws in our study is higher than the 11% found in 2012 in the Lobaye region [4]. We also identified 57 cases of leprosy by screening; 68.42% (n= 39) were multibacillary. Among children younger than 15 years, 8 (16.66%) had grade 2 impairments. The screening rate for new cases is 13.333 per 10 000, quite substantially higher than the mean rate of 2.9 per 10 000 for the 121 countries and territories of this WHO region in 2016 [6]. Among the cases screened during the study, 51% (n=29/57) were already known to healthcare facilities. This study demonstrates the extent of the NTDs in Lobaye in the Central African Republic.

[Leprosy survey conducted in the Central African Republic from 1982 to 1985 among the Ba-Benzele Pygmies]. / Enquête sur la lèpre en République Centrafricaine, de 1982 à 1985, chez les Pygmées Ba-Benzélé.

A leprosy survey was conducted from 1982 to 1985 among 2650 semi-sedentarized Pygmies in two camp-villages in the Central African Republic. Leprosy is endemic there, with an estimated prevalence rate of 1.05% and an annual detection rate of 0.2%. In view of its close relations with other neighbouring ethnic groups this Pygmy community can be considered as a target population the study of which provides indications on the transmission and typical course of leprosy in the region and also as a potential focus of contamination. However, the concurrent presence of endemic tuberculosis made it necessary during the survey to look for clinical associations of leprosy and tuberculosis in patients so that the standard multidrug treatment schedules comprising rifampicin could be adjusted accordingly.

[A survey of the prevalence of leprosy in 5 countries in central Africa]. / Enquêtes de prévalence de la lèpre dans 5 pays d'Afrique Centrale.

The authors report the results of national surveys conducted in 5 Central Africa states: Cameroon, Congo, Gabon, Equatorial Guinea and RCA. The method used was cluster sampling among random populations. Only adults (greater than 15 years of age) took part in the study. The prevalence rates were between 6 and 14 per thousand. They are markedly higher than the official data.

[Polychemotherapy of leprosy in the Central African Republic, 1987]. / La polychimiothérapie de la lèpre en République Centrafricaine, en 1987.

The Central African Republic, which once had the highest Hansen disease prevalence rate in the Central African States, had exemplary results in the control carried out on the basis of sulfonic monotherapy since 1958. In 1983, a cluster sample survey in Upper-Sangha seemed to show that the prevalence of the disease was underestimated. It then became necessary to adopt a new national strategy whose objective would be to reduce the prevalence of leprosy in the country by 50% within five years. For this, a "National Programme for the Control of Leprosy in C.A.R." has been developed; in part it foresees the setting up of polychemotherapy for patients. These treatment protocols should insure healing of paucibacillary forms within six months and of multibacillary forms within twenty-four months. The new strategy of screening and decentralized treatment required retraining personnel and combining health education at individual and collective levels. The preliminary results of a national survey for the evaluation of the prevalence of leprosy are presented.