Factors enhancing the control of Buruli ulcer in the Bomfa communities, Ghana

Abstract

This study examines factors that may enhance the control and holistic treatment of Buruli ulcer in an endemic area of the Ashanti Region in Ghana. A total of 189 Buruli ulcer patients from the Bomfa sub-district were treated at the Global Evangelical Mission Hospital, Apromase-Ashanti, Ghana, from January to December 2005. Diagnosis was based on clinical findings and confirmed by any two positives of Ziehl-Neelson test for acid fast bacilli, polymerase chain reaction and histopathology. Children up to age 14 made up 43.4% of the cases; male: female ratio was 3:2. The mean duration of hospitalization was 77 days and hospital stay was significantly correlated with the time spent at home with the disease prior to admission; also, 76.7% of the cases were late ulcers. Of the 189 patients, 145 (i.e. 76.7%) were treated with antibiotics and surgery which involved excision, skin grafting with or without contracture release. A follow-up survey after the introduction of the psychosocial approach recorded fewer (85) new Buruli ulcer (BU) cases of which, the majority (78.8%, 67) were nodules and only 21.2% (18) were ulcers. Health education plays a major role in the holistic treatment of BU. This paper proposes a further study in other endemic areas on the treatment of BU with emphasis on psychosocial approach for holistic treatment.

The use of ozone therapy in Buruli ulcer had an excellent outcome

“…This approach, together with a holistic approach to the patient with BU, including health education,10 could permit BU treatment and control.…”

Buruli ulcer: wound care and rehabilitation

“…Contractures (Figure 3) are treated by surgical release and deformities are corrected by reconstructive surgery. [101][102][103] However, the option of surgery may not be readily available or affordable in endemic countries.…”

Elucidation of Macroeconomic Determinants for Prognosis of Buruli Ulcer

“…Additionally, although there is no evidence that transmission of disease is from one human to another, education about disease transmission in patients can reduce the incidence. It is practice of better hygiene, which researchers have described as "well-informed" patients living in same geographical region with their improved practice of hygiene, "environment" for disease spread also get changed, which might help to reduce new occurrence of ailments further [16]. Improved water access in rural areas, where Buruli Ulcer is most prevalent and ability to avail better sanitation facilities seems to be prima facie factors in the context of prognosis of Buruli Ulcer.…”