Socio-cultural dimensions of buruli ulcer infection in the Upper Denkyira district

Abstract

Buruli ulcer, a disease of the skin is endemic in some parts of Ghana and currently has no cure. Researches are still being conducted to get more information on the disease. This study assessed the perception of and reactions to the disease, the coping and supporting mechanisms among affected persons and other members in the households of affected persons. It also explored the socio-cultural dimensions of predisposing factors to the disease in the study area using a modified proximate determinants model. Data were collected through focus group discussions and field observation and interviewing 100 Buruli patients (51 females and 49 males), 100 relatives of patients and eight opinion leaders. Six hundred and sixty three (663) members from the households of 100 relatives (142 patients and 521 without the disease) were also interviewed. Results from the study indicated that intermediate factors such as injury, environmental contamination, nutrition, personal illness control, household size, education, occupation and income influence the contraction of the disease. The disease affected more women aged between 20-49 than men in the same age category. This is because by their traditional role, women were more exposed to the element of injury, making them more vulnerable to the disease. It was also observed that children less than 10 years of age were less at risk of Buruli ulcer infection as compared to those 10 years and above, as a result of differential contact within the physical environment. Peoples' perception of what constituted the causative agent influenced health-seeking behaviour. About 90 percent of the Buruli patients and their relatives have accepted the Buruli situation and were adopting innovative measures to treat it. The family (especially parents and sisters) is a major source of support to Buruli patients. As a disease of the environment, health education is very important in dealing with the spread and treatment of infection. To this end, audio-visual aids and demonstrations on preventive and treatment measures are needed to enhance health education. The Ministry of Health should implement concerns of Buruli ulcer in its policies and should monitor the implementation of free treatment of the disease in order to ease the burden of purchasing drugs outside the hospital. The District Assembly should take steps to ensure that funds from the Government's Poverty Reduction Strategy Programme are made available to assist endemic communities with poor access to health facilities. A proposed Buruli Ulcer Fund Initiative (BUFI) should be set up and contributions from religious bodies, Non Governmental Organisations (NGOs), companies and individuals put into it in the bid to assist Buruli patients.