Help-Seeking for Pre-Ulcer and Ulcer Conditions of Mycobacterium ulcerans Disease (Buruli Ulcer) in Ghana

Abstract

Abstract. This study examined sociocultural features of help-seeking for Buruli ulcer-affected persons with pre-ulcers and ulcers in a disease-endemic area in Ghana. A sample of 181 respondents were purposively selected. Fisher's exact test was used to compare help-seeking variables for pre-ulcers and ulcers. Qualitative phenomenologic analysis of narratives clarified the meaning and content of selected quantitative help-seeking variables. For pre-ulcers, herbal dressings were used to expose necrotic tissues and subsequently applied as dressings for ulcers. Analgesics and left-over antibiotics were used to ease pain and reduce inflammation. Choices for outside-help were influenced by the perceived effectiveness of the treatment, the closeness of the provider to residences, and family and friends. Health education is required to emphasize the risk of self-medication with antibiotics and the importance of medical treatment for pre-ulcers, and to caution against the use of herbs to expose necrotic tissues, which could lead to co-infections.

Socio-cultural determinants of timely and delayed treatment of Buruli ulcer: implications for disease control

“…However, the situation reversed after one year of intensive health education[29]. The impact of this practice has been reported in another paper [30]. …”

“…In South Africa, off-road motorcycles have been used for timely collection of blood-specimens that give remote clinics access to diagnostic laboratory services [35]. Collaborating with private health practitioners might also be considered as a pragmatic and cost-effective approach to improve access [30,36]. However, this intervention requires supervision and monitoring by the municipal health management team to ensure that drug protocols are followed strictly and wounds are managed properly.…”

“…Herbalists play a crucial role in providing services when biomedical treatment is inaccessible, particularly in a culture where herbal medicine is widely used [38]. Previous studies recommend their integration in the health system to facilitate referrals [3,30]. Currently, herbalists are being motivated to refer patients to health facilities, in the study areas (personal communication).…”

“…Support networks such as family and friends provide social support and offer valuable help-seeking advice. [4,30,44,45]. The importance of community and school health education programmes to increase awareness of BU, and the availability and effectiveness of treatment at medical facilities cannot be overemphasised.…”

Perceptions on the Effectiveness of Treatment and the Timeline of Buruli Ulcer Influence Pre-Hospital Delay Reported by Healthy Individuals

“…Other treatment options perceived as conventional by people in Benin are self-medication and traditional (or herbal) treatment [9]–[11]. A recent study conducted in Ghana emphasizes the preference for herbal treatment, especially of patients with Buruli ulcer in an early pre-ulcerative stage [12]. Some of the major treatment centers located in the endemic south of Benin adhere to the WHO guidelines on antibiotics while others use surgery as the dominant treatment modality.…”