Abstract
BackgroundBuruli ulcer may induce severe disabilities impacting on a person's well-being and quality of life. Information about long-term disabilities and participation restrictions is scanty. The objective of this study was to gain insight into participation restrictions among former Buruli ulcer patients in Ghana and Benin.MethodsIn this cross-sectional study, former Buruli ulcer patients were interviewed using the Participation Scale, the Buruli Ulcer Functional Limitation Score to measure functional limitations, and the Explanatory Model Interview Catalogue to measure perceived stigma. Healthy community controls were also interviewed using the Participation Scale. Trained native interviewers conducted the interviews. Former Buruli ulcer patients were eligible for inclusion if they had been treated between 2005 and 2011, had ended treatment at least 3 months before the interview, and were at least 15 years of age.ResultsIn total, 143 former Buruli ulcer patients and 106 community controls from Ghana and Benin were included in the study. Participation restrictions were experienced by 67 former patients (median score, 30, IQR; 23;43) while 76 participated in social life without problems (median score 5, IQR; 2;9). Most restrictions encountered related to employment. Linear regression showed being female, perceived stigma, functional limitations, and larger lesions (category II) as predictors of more participation restrictions.ConclusionPersisting participation restrictions were experienced by former BU patients in Ghana and Benin. Most important predictors of participation restrictions were being female, perceived stigma, functional limitations and larger lesions.
Highlights
Buruli ulcer (BU) is a skin condition caused by Mycobacterium ulcerans, which is the third most prevalent mycobacterial disease in immuno-competent humans, after the diseases caused by Mycobacterium tuberculosis and Mycobacterium leprae [1]
This study showed that almost half of the former Buruli ulcer patients encountered problems in social life, especially related to employment
Eligible for inclusion were former BU patients aged at least 15 years, who were treated between 2005 and 2011, and whose treatment was completed at least 3 months before the study commenced
Summary
Buruli ulcer (BU) is a skin condition caused by Mycobacterium ulcerans, which is the third most prevalent mycobacterial disease in immuno-competent humans, after the diseases caused by Mycobacterium tuberculosis and Mycobacterium leprae [1]. The lesion breaks open with ulceration typically presenting with undermined edges [2]. In 2011, Cote d’Ivoire, Ghana and Benin reported the highest numbers of new cases [4]. In Benin, the prevalence varies from 5.4 cases/10,000 to 60.7/ 10,000 inhabitants depending on altitude of villages [5] while the national BU prevalence in Ghana is 20.7 cases/100,000 inhabitants [6]. Buruli ulcer may induce severe disabilities impacting on a person’s well-being and quality of life. Information about long-term disabilities and participation restrictions is scanty.
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