We identified risk factors for Buruli ulcer (BU) in Benin in an unmatched case-control study at the Centre Sanitaire et Nutritionnel Gbemoten in southern Benin. A total of 2,399 persons admitted from 1997 through 2003 and 1,444 unmatched patients with other conditions in 2002 were recruited. Adjusted odds ratios were determined for age, sex, place of residence, Mycobacterium bovis BCG vaccination at birth, type of water for domestic use, and occupation. Children <15 years of age and adults>49 years of age had a higher risk for BU. Use of unprotected water from swamps was associated with increased risk for BU; ...

<15 years old. Children 3-4 years old had an increased risk for BU if they used unprotected water and lived in areas endemic for BU. That clothing provides protection against BU has already been reported in Cote d'Ivoire (3). In Africa, infants [less than or equal to] 1 year of age are often protected by clothes, bonnets, and booties. At [approximately equal to] 1-2 years of age, children begin to walk and play in dirt near their home, and those 3-4 years of age are more independent and roam freely in the environment, usually scantily clothed, which increases exposure to a contaminated environment. Use of unprotected water increases BU risk (OR><59-year-old group were equally at risk (11). Our present study did not confirm sex differences in either those>