Psychosocial aspects of health seeking behaviours of patients with Buruli ulcer in southern Benin (original) (raw)
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Advances in Applied Sociology, 2012
Buruli ulcer (BU) has been associated with very unimaginable outcomes. It is flesh eating, disfiguring and economically dehydrating. Yet the disease is still mostly shrouded in mystery. Consequently, people have different perceptions about it and hence adopt different treatment behaviors towards it; notwithstanding the free treatment for it. The purpose of this paper is to identify and examine respondents' perceptions and the influence these have on their health seeking behaviors. Eighty-six BU patients who had been treated or were being treated of BU in the Ga West District Health Center in Ghana were sampled for this study. A structured questionnaire and a qualitative in-depth interview guide were used to elicit the data. Some of the interviewees held the belief that the disease is caused by their adversaries, including witches. More than half of the respondents, however, did not have any idea about the disease and thought it is just the work of God. The first point of call for health care for most of the patients studied was herbalists or else they used herbs. Nearly a quarter of them also engaged in self medication, including the use of 'pain killers' and ointments, since they took the first signs for ordinary boils. Perceptions of the cause of the disease influenced health seeking behaviors, which further influenced treatment outcomes. A lot of education is needed on the symptoms of the disease, including encouraging early seeking of care at the District Health Center.
Beliefs and attitudes toward Buruli ulcer in Ghana
The American journal of tropical medicine and hygiene, 2002
Buruli ulcer is a devastating emerging disease in tropical countries. Quantitative and qualitative data were obtained by interviewing patients with this disease and control subjects in Ghana. Common perceived causes were witchcraft and curses. Other reported causes were personal hygiene, environment, and close contact with a patient with this disease. Financial difficulties, fear of the mutilating aspects of treatment, and social stigma were the main reasons found for delay in obtaining treatment. Patients are reluctant to seek treatment outside their own community. Patients often expected medical treatment instead of surgery, and underestimated the duration of hospital admission. The stigma of the disease is huge, and is strongly associated with the mysterious nature of the condition, the lack of knowledge about its mode of transmission, and the lack of proper treatment. Stigma scores were higher in unaffected respondents and in a less endemic location. Education on the disease, us...
Tropical Medicine & International Health, 2007
Buruli ulcer disease (BUD), a devastating tropical disease caused by Mycobacterium ulcerans, occurs in more than 80% of the administrative districts of Ghana. To elucidate community perceptions and understanding of the aetiology of BUD, attitudes towards Buruli patients and treatment-seeking behaviours, we conducted a survey with 504 heads of households and seven focus group discussions in Ga West District, Ghana. Although 67% of participants regarded BUD as a health problem, 53% did not know its cause. Sixteen per cent attributed the cause to drinking non-potable water, 8.1% mentioned poor personal hygiene or dirty surroundings, and 5.5% identified swimming or wading in ponds as a risk factor. About 5.2% thought that witchcraft and curses cause BUD, and 71.8% indicated that BU sufferers first seek treatment from herbalists and only refer to the hospital as a last resort. The main reasons were prospects of prolonged hospital stay, cost of transport, loss of earnings and opportunity associated with parents attending their children's hospitalization over extended period, delays in being attended by medical staff, and not knowing the cause of the disease or required treatment. The level of acceptance of BUD sufferers was high in adults but less so in children. The challenge facing health workers is to break the vicious cycle of poor medical outcomes leading to poor attitudes to hospital treatment in the community. Because herbalists are often the first people consulted by those who contract the disease, they need to be trained in early recognition of the pre-ulcerative stage of Buruli lesions.
International Research Journal of Public Health
Research Article IRJPH (2020) 4:43 Health seeking behaviour for Buruli Ulcer disease in the Obom subdistrict of the Ga south Municipality of Ghana The current biomedical Buruli ulcer case management strategies emphasise the importance of early reporting and appropriate medical treatment of nodules before they ulcerate and give rise to deformities and disabilities. However, there are a wide range of factors that influence health seeking behaviour for Buruli ulcer case management. The purpose of the study was to determine health seeking behaviour for Buruli ulcer by affected persons and their families. This was a descriptive study involving both qualitative and quantitative data collection. Thirty (30) in-depth interviews were conducted for Buruli ulcer patients and their corresponding caregivers on barriers and facilitators to health seeking. Three (3) Focus Group Discussions (FGDs) were also conducted among elderly community members. Survey questionnaire interviews were conducted with 300 community respondents in Ga, Akan and Ewe languages in the study area. Systematic sampling was used to select 300 respondents for the survey. The study revealed that most respondents (41.0%) would resort to self-medication as their first treatment option when infected with Buruli ulcer. However, the health seeking of selfmedication before seeking biomedical treatment was alarming since it leads to delays in reporting. This is a serious public health concern since delay in reporting could lead to category three lesions.
Advances in Applied Sociology
Community knowledge and perceptions of the cause and consequently the appropriate measure to remedy an ailment determine whom people turn to for advice, help, information and treatment when bogged down with a disease. The role that community plays in the etiology, explanation, prognosis and treatment seeking behaviour cannot be underscored, because it provides in-depth information on the burden of the disease, the local understanding of the causes of the disease and therefore its management. The purpose of the study was to describe community knowledge and perceptions about Buruli ulcer (BU) and how to prevent Buruli ulcer in the Obom sub-district of Ghana. Survey questionnaire was used as an instrument for data collection to solicit information on community knowledge and perceptions of Buruli ulcer in the communities. In selecting respondents for the community survey, systematic sampling was used to select 300 respondents for the study. The study revealed a high level of knowledge about Buruli ulcer in the selected endemic communities. However, Buruli ulcer patients were perceived as people who have been bewitched (36.7%). Others (21%) blamed them as people who did not take good care of themselves while another 11.1% saw Buruli ulcer infected people as having normal wounds. Findings therefore show that although there was a high knowledge of signs and symptoms of Buruli ulcer among community members in the Obom sub-district, their understandings and interpretations of its causative factors varied from those of the biomedical understandings. Based on the results of the study, it is recommended that community outreach and education on the treatment and management of Buruli ulcer should be continued on a sustainable basis in the endemic communities.
Transactions of The Royal Society of Tropical Medicine and Hygiene, 2008
Buruli ulcer is a devastating condition emerging in West Africa. We investigated why patients often report late to the hospital. Health seeking behaviour determinants and stigma were studied by in-depth interviews in patients treated in hospital (n = 107), patients treated traditionally (n = 46) of whom 22 had active disease, and healthy community control subjects (n = 107). We developed a model capturing internal and external factors affecting decision making. With increasing severity, extent and duration of Buruli ulcer, a shift of influencing factors on health seeking behaviour appears to occur. Factors causing delay in presenting to hospital were the use of traditional medicine before presenting at the treatment centre; costs and duration of admission; disease considered not serious enough; witchcraft perceived as the cause of disease; and fear of treatment, which patients expected to be amputation. This study confirms the importance of self-treatment and traditional healing in this area. Our study was performed before antimicrobial treatment was introduced in Benin; we suggest that this model and the results from this analysis should be used as a baseline from which to measure the influence of the introduction of antimicrobial treatment on health seeking behaviour for Buruli ulcer in Benin.
2016
Background: Buruli ulcer (BU) is a neglected tropical disease affecting the skin, tissues and in some cases the bones, caused by the environmental pathogen Mycobacterium ulcerans (M. ulcerans). Its mode of transmission is still elusive. Delayed treatment may cause irreversible disabilities with consequent social and economic impacts on the victim. Socio-cultural beliefs, practices and attitudes in endemic communities have been shown to influence timely treatment causing disease management, prevention and control a great challenge. An assessment of these factors in endemic localities is important in designing successful intervention strategies. Considering this, we assessed the knowledge, attitude and practices regarding BU in three endemic localities in the South West region, Cameroon to highlight existing misconceptions that need to be addressed to enhance prompt treatment and facilitate effective prevention and control. Methods and Findings: A cross-sectional study was executed in three BU endemic health districts. Using qualitative and quantitative approaches we surveyed 320 randomly selected household heads, interviewed BU patients and conducted three focus group discussions (FGDs) to obtain information on awareness, beliefs, treatment, and attitudes towards victims. The influence of socio-demographic factors on these variables was investigated. Results: Respondents (84.4%) had a good knowledge of BU though only 65% considered it a health problem while 49.4% believed it is contagious. Socio-demographic factors significantly (P<0.05) influenced awareness of BU, knowledge and practice on treatment and attitudes towards victims. Although the majority of respondents stated the hospital as the place for appropriate treatment, FGDs and some BU victims preferred witch-doctors/herbalists and prayers, and considered the hospital as the last option. We documented beliefs about the disease which could delay treatment. Conclusion: Though we are reporting a high level of knowledge of BU, there exist fallacies about BU and negative attitudes towards victims in communities studied. Efforts towards disease eradication must first of all target these misconceptions.
BMC Public Health, 2012
Background: Ghana is a Buruli ulcer (BU) endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra.
Journal of Medical Care Research and Review, 2020
A study was carried out in Oguta One community of Oguta Local Government Area to determine the prevalence and perceptions in the management of Buruli Ulcer among residents. Interviews and structured questionnaire were used for case finding and to obtained information on knowledge and perception. Physical examination and standard bacteriological techniques were used to confirm BU cases. The result showed a prevalence of 0.2% out of the 356 participants. There was knowledge of the disease but poor understanding of its cause and mostly perceived to be a supernatural disease by which treatment could be sought from herbal homes and churches. Age, Education and occupation had strong association (P<0.05) with the knowledge of Buruli ulcer with the exception of sex (P>0.05). From these findings, it is evident that a more robust case finding is necessary in the country as many cases would be missed without the inclusion of herbal/trado-medical homes and churches in control programs esp...
PLoS neglected tropical diseases, 2018
In the Cameroon, previous efforts to identify Buruli ulcer (BU) through the mobilization of community health workers (CHWs) yielded poor results. In this paper, we describe the successful creation of a BU community of practice (BUCOP) in Bankim, Cameroon composed of hospital staff, former patients, CHWs, and traditional healers. All seven stages of a well-defined formative research process were conducted during three phases of research carried out by a team of social scientists working closely with Bankim hospital staff. Phase one ethnographic research generated interventions tested in a phase two proof of concept study followed by a three- year pilot project. In phase three the pilot project was evaluated. An outcome evaluation documented a significant rise in BU detection, especially category I cases, and a shift in case referral. Trained CHW and traditional healers initially referred most suspected cases of BU to Bankim hospital. Over time, household members exposed to an innovat...