Abstract

IntroductionAfter tuberculosis and leprosy, Buruli ulcer (BU) is the third most common mycobacterial infection. Buruli ulcer begins as a localized skin lesion that progresses to extensive ulceration thus leading to functional disability, loss of economic productivity and social stigma. This study is aimed at assessing the knowledge and practices among health practitioners on the treatment of BU in the Mbonge, Ekondo Titi and Muyuka Health Districts of the South West Region of Cameroon.MethodsThis is a cross-sectional study that investigates participants' knowledge and practices on the treatment of BU. The study uses a qualitative method of structured questionnaires in the process of data collection.ResultsSeventy percent (70%) of the participants acknowledged they encounter cases of BU in their respective Hospitals or Health centers. Among these, 48% agreed they managed BU in their facilities and up to 91.7% noted that their community members are aware that BU is managed in their facility while seventy percent of the medical practitioners indicated they cannot identify the various stages of BU. Eighty-one percent of the practitioners from Muyuka HD indicated they could not identify the various stages of BU. More than 63% of the practitioners regarded BU patients as normal people in their communities however, practitioners that practiced for less than 5 years were likely not to admit BU patients in the same room with other patients. Beliefs such as being cursed (47.06%) and being possessed (29.41%) were reported by practitioners that acknowledged the existence of traditional beliefs in the community.ConclusionDespite the fact that a majority of the health practitioners knew what BU is, most of them demonstrated lack of knowledge on the identification of the various stages and management of the illness. Practitioners demonstrated positive attitude towards patients although they would not admit them in the same room with other patients. Considering the poor knowledge on identification and management demonstrated by most of the practitioners, management of the disease would be inadequate and may even aggravate the patient's situation. Training and onsite mentorship on screening, identification and management of BU is therefore highly recommended amongst health personnel practicing in endemic areas.

Highlights

  • After tuberculosis and leprosy, Buruli ulcer (BU) is the third most common mycobacterial infection [1]

  • 48% agreed they managed BU in their facilities and up to 91.7% noted that their community members are aware that BU is managed in their facility

  • Stratification of the participants with respect to various Hospitals/Health Centers gave a better understanding about knowledge on treatment of BU

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Summary

Introduction

Buruli ulcer (BU) is the third most common mycobacterial infection [1]. Bairnsdale ulcer and Daintree ulcer are all local names given to the same disease that is caused by Mycobacterium ulcerans. The responsible organism is an acid-fast Mycobacterium of the same genus as the tuberculosis bacilli. This environmental bacterium produces a destructive toxin and mycolactone which leads to tissue damage that inhibits the immune response [3]. M. ulcerans infects the skin and subcutaneous tissues that progresses to indolent nonulcerated and ulcerated lesions [4]. The first report of Buruli ulcer from Africa dates back to 1897 when Sir Albert Cook described cases of chronic ulceration in Uganda, the first definitive description of Mycobacterium ulcerans was published in 1948 [4]

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