Factors associated with functional limitations and subsequent employment or schooling in Buruli ulcer patients

Abstract

Summaryobjectives To evaluate former Buruli ulcer disease (BUD) patients to assess the factors associated with functional limitations and subsequent employment or schooling.methods The previously validated Buruli ulcer functional limitation score (BUFLS) questionnaire and interviews about educational and professional consequences incurred by BUD.results Of 638 participants, 362 (57%) had a functional limitation after a median period of almost 4 years after treatment for BUD. A lesion on a joint, older age, female gender, a lesion on a distal part of an extremity and a persistent wound were found to be independent risk factors for stopping work or education. The same risk factors applied to the development of a functional limitation. Both functional limitations and financial difficulties due to BUD disease often led to job loss and school dropout.conclusions Rehabilitation programmes are urgently needed to diminish the suffering from the functional limitations and employment or schooling problems caused by BUD.

Buruli Ulcer Control in a Highly Endemic District in Ghana: Role of Community-Based Surveillance Volunteers

“…2,3 The currently recommended treatment of 8 weeks of streptomycin and rifampicin is highly effective in resolving the infection, 4 but with late presentation, most ulcers require surgery and prolonged hospitalization and have a higher risk of contractures and disability. 5,6 A relevant measure of early reporting is the size of the lesion, which is reflected by the World Health Organization (WHO) categorization system for BU. In this system, a category I lesion is below 5 cm in cross-sectional diameter, a category II lesion is between 5 and 15 cm in diameter, and a category III lesion is larger than 15 cm in diameter or involving critical sites (e.g., the eye or genitals).…”

The Application of Modern Dressings to Buruli Ulcers: Results from a Pilot Implementation Project in Ghana

“…3 Large scars and contractures may result in functional limitations. 4,5 A high standard of wound care reduces the burden on both the patient and the health-care system, as it shortens the time it takes for a wound to heal and prevents secondary infections of the wound. A guideline on BU wound care is provided by the World Health Organization (WHO) in a manual on prevention of disabilities.…”

Economic inequality caused by feedbacks between poverty and the dynamics of a rare tropical disease: the case of Buruli ulcer in sub-Saharan Africa

“…For individuals under medical treatment, w i ¼ w T and it is associated with hospitalization or daily visits to the healthcare centre that are responsible for the great indirect costs of the disease [21,22,34]. We attribute disabled individuals a reduced human capital, w i ¼ w D , to account for their reduced ability to work and the impact of functional limitations on school abandon and job loss [27,28], which is reinforced by the strong social stigma and mystical beliefs associated with the disease [35,36]. Finally, physical capital, k, represents individual's wealth, and its accumulation over time results from the investment of a proportion of current income at rate r k , while it depreciates at rate d k :…”

“…Treatment of these severe stages requires, in addition to the standard eight-week antibiotic therapy [23], surgical procedures involving debridement, skin grafts and much longer hospital stays [24][25][26]. Contraction of joint movement and functional limitations for life are a common outcome of large ulcers [26,27], which is associated with loss of employment and school abandon [28]. Despite its devastating consequences, measuring the economic impact of such a rare disease in endemic populations is challenging.…”