Social and Economic Factors Influencing Buruli Ulcer Health Seeking Decision Making in the Ga West and South Municipalities

Abstract

Background: Buruli ulcer infection is generally referred to as a re-emerging disease with the highest burden in West Africa. In Ghana, about 1000 cases are reported annually. The former Ga district (now the Ga West and Ga South municipalities) continues to report the highest proportion of the worst ulcerated wounds in Ghana, despite various interventions implemented. The aim of this study was to determine factors affecting treatment-related decision making in BU affected families. Methods: Semi-structured questionnaire interview was conducted with 33 patients (≥15 years) and seven caretakers of children aged below 15 years to determine the social and economic factors influencing BU-related health seeking decision making and types of treatment choices that are made. Results: Respondents were afflicted with varied categories of the disease (category one (30%), category two (35%) and category three (35%)). Decisions to seek health care from biomedical facilities are influenced by factors such as advice from health workers (45.0%) and advice from family members (42.5%). Only a quarter (25%) of respondents actually mentioned "financial considerations" as one of the factors that influence their decision to seek for biomedical care. Whereas there was no significant relationship between family involvement in treatment decision making and category one (p = 0.5351) lesion, there was a significant relationship between family involvement in treatment decision making and categories two (p = 0.0434) and three (p = 0.0089) lesions. Conclusion: It appears from this study that financial consideration, which has been widely cited as a cause of treatment delay may be losing its influence to social factors. With the advent of free antibiotics treatment more studies are needed to identify social factors affecting BU treatment decision making so as to redesign health promotion messages appropriately, especially those aimed at getting patients into early treatment.

Knowledge and Management of Buruli Ulcer Disease: A Case Study at Sekyere Afram Plains District of Ashanti Region, Ghana

“…Furthermore, it was anticipated that Christians and Muslims, based on their religious beliefs, religion should have a positive association with the knowledge on BU, however, this study found that religion was not statistically associated with the knowledge of the participants on BU. Another study corroborated the findings of this study and identified that although the majority of respondents stated the hospital as the place for appropriate treatment, some BU victims preferred witchdoctors/herbalists and prayers, and considered the hospital as the last option which was not statistically significant [11].…”

“…Although the study showed a colossal (68.2%) failed to report at the health facility, 78% admitted that the health facility could manage their condition better. This has been confirmed in a study which found that access to health services encouraged timely treatment of Buruli ulcer patients [11].…”

“…There have been a few isolated cases found in non-endemic areas of North America and Europe, however these cases have been linked to international travel [10]. In 2018, cases were reported in 14 nations, the most of which are in Africa, where the majority of the disease control efforts have been focused [11]. In the worst cases, Buruli ulcer leaves victims with disfiguring and disabling craters after silently eating through their skin, muscle, and bone [12].…”

Implementing active community-based surveillance-response system for Buruli ulcer early case detection and management in Ghana

“…The socio-demographic characteristics of the study area has remained virtually the same as was reported in earlier studies [12,15,17,18,26], where the Ga ethnic groups were dominant with majority of them identifying with the Christian religion with primary level education. The knowledge of the disease was very high among respondents, gained mostly through the experiences of knowing someone with the infections.…”

“…However, it has been reported that community-based interventions could enhance case detection and reduced treatment dropout and defaulter rates [17, 18]. …”