AbstractsMedical & Health Science

Health-seeking behaviour of Buruli Ulcer affected people in a rural sub district of the Eastern Region, Ghana

by Linda Maria Seefeld

Institution: Universität Bielefeld
Degree: PhD
Year: 2015
Record ID: 1098793
Full text PDF: http://pub.uni-bielefeld.de/publication/2730302


Introduction Buruli ulcer (BU) is one of the least studied neglected tropical diseases. It is a chronic necrotising skin and soft tissue disease that may also affect the bone. The majority of BU affected people seek medical care only at an advanced stage of the disease. This is often associated with severe disabilities and goes along with social implications (e.g. increased treatment expenses, impaired capacity to work, stigmatisation and social exclusion). Early diagnosis and antibiotic treatment would simplify the treatment and reduce morbidity as well as the involved social and economic constraints. Nevertheless, research into reasons for delayed medical treatment and local perceptions of BU is still insufficient. Aim of the Study This study draws on the need for a better understanding of the local BU specific disease concept and the related health-seeking behaviour. Its primary aim was to adapt an existing instrument (Kroeger’s Framework (1983)) to explain the BU specific health-seeking behaviour as well as to apply and evaluate it on the basis of different research methods. In this course characteristics of people who reported late to governmental health facilities were identified. In addition, measures for improving the disease specific treatment and control as well as health education activities were identified. The suitability of the applied research methods to assess the individual variables of the framework was evaluated to collect relevant data easier and more efficient in the future. Methods The research was carried out in a rural sub district of the Eastern Region (Ghana). An iterative process using qualitative as well as quantitative research methods was applied. To explore the published evidence on aspects influencing BU specific health-seeking behaviour and to analyse them in a structured way Kroeger’s Framework for health-seeking behaviour (1983) and a systematic literature search served as starting points. To obtain details about local disease concepts, perceptions and treatment practices expert interviews were done. An active community case search (door-to-door screening) in the study area (48 communities, about 23,000 inhabitants) allowed for conducting a knowledge, attitude and practice (KAP) survey among presently and previously BU affected people (N=122) as well as matched non-affected community members (N=122) (similar age and same sex) to identify and assess differences between these two groups. Focus group discussions (FGDs) in selected communities were organized to reveal differences with respect to the disease perception across the research area as well as between previously BU affected and non-affected people. Results The analysis of 22 retrieved papers allowed for an assessment of the different aspects of health-seeking behaviour according to the literature and the development of the ‘Adapted BU specific Framework for Health Seeking Behaviour’ (version I). 33 expert interviews provided details about the local disease perceptions (e.g. only traditional herbal treatment may heal the…