socio-cultural determinants of timely and delayed treatment of buruli ulcer implications for disease control社会文化因素及时和延迟治疗疾病控制布鲁里溃疡的影响.pdfVIP

Ackumey et al. Infectious Diseases of poverty 2012, 1:6 /content/1/1/6 RESEARCH ARTICLE Open Access Socio-cultural determinants of timely and delayed treatment of Buruli ulcer: implications for disease control 1,2,3* 1,4 1 5 2,3 Mercy M Ackumey , Margaret Gyapong , Matilda Pappoe , Cynthia Kwakye Maclean and Mitchell G Weiss Abstract Introduction: Public health programmes recommend timely medical treatment for Buruli ulcer (BU) infection to prevent pre-ulcer conditions from progressing to ulcers, to minimise surgery, disabilities and the socio-economic impact of BU. Clarifying the role of socio-cultural determinants of timely medical treatment may assist in guiding public health programmes to improve treatment outcomes. This study clarified the role of socio-cultural determinants and health system factors affecting timely medical treatment for BU in an endemic area in Ghana. Methods: A semi-structured explanatory model interview based on the explanatory model interview catalogue (EMIC) was administered to 178 BU-affected persons. Based on research evidence, respondents were classified as timely treatment (use of medical treatment 3 months from awareness of disease) and delayed treatment (medical treatment 3 months after onset of disease and failure to use medical treatment). The outcome variable, timely treatment was analysed with cultural epidemiological variables for categories of distress, perceived causes of BU, outside-help and reasons for medical treatment in logistic regression models. The median time for the onset of symptoms to treatment was computed in days. Qualitative phenomenological analysis of respondents’ narratives clarified the meaning,