Volume 85, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



This study examined sociocultural features of help-seeking for Buruli ulcer–affected persons with pre-ulcers and ulcers in a disease-endemic area in Ghana. A sample of 181 respondents were purposively selected. Fisher's exact test was used to compare help-seeking variables for pre-ulcers and ulcers. Qualitative phenomenologic analysis of narratives clarified the meaning and content of selected quantitative help-seeking variables. For pre-ulcers, herbal dressings were used to expose necrotic tissues and subsequently applied as dressings for ulcers. Analgesics and left-over antibiotics were used to ease pain and reduce inflammation. Choices for outside-help were influenced by the perceived effectiveness of the treatment, the closeness of the provider to residences, and family and friends. Health education is required to emphasize the risk of self-medication with antibiotics and the importance of medical treatment for pre-ulcers, and to caution against the use of herbs to expose necrotic tissues, which could lead to co-infections.


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  1. World Health Organization, 2008. Buruli ulcer: progress report, 2004–2008. Wkly Epidemiol Rec 83: 145154.
  2. Amofah GK, Sagoe-Moses C, Adjei-Acquah C, Frimpong EH, , 1993. Epidemiology of Buruli ulcer in Amansie West district, Ghana. Trans R Soc Trop Med Hyg 87: 644645.[Crossref]
  3. Asiedu K, Etuaful S, , 1998. Socioeconomic implications of Buruli ulcer in Ghana: a three-year review. Am J Trop Med Hyg 59: 10151022.
  4. Marston BJ, Diallo MO, Horsburgh CR, Jr Diomande I, Saki MZ, Kanga JM, Patrice G, Lipman HB, Ostroff SM, Good RC, , 1995. Emergence of Buruli ulcer disease in the Daloa region of Côte d'Ivoire. Am J Trop Med Hyg 52: 219224.
  5. Johnson PD, Stinear T, Small PL, Pluschke G, Merritt RW, Portaels F, Huygen K, Hayman JA, Asiedu K, , 2005. Buruli ulcer (M. ulcerans infection): new insights, new hope for disease control. PLoS Med 2: e108.[Crossref]
  6. Amofah G, Bonsu F, Tetteh C, Okrah J, Asamoa K, Asiedu K, Addy J, , 2002. Buruli ulcer in Ghana: results of a national case search. Emerg Infect Dis 8: 167170.[Crossref]
  7. Mulder AA, Boerma RP, Barogui Y, Zinsou C, Johnson RC, Gbovi J, van der Werf TS, Stienstra Y, , 2008. Healthcare seeking behaviour for Buruli ulcer in Benin: a model to capture therapy choice of patients and healthy community members. Trans R Soc Trop Med Hyg 102: 912920.[Crossref]
  8. Phanzu DM, Bafende EA, Dunda BK, Imposo DB, Kibadi AK, Nsiangana SZ, Singa JN, Meyers WM, Suykerbuyk P, Portaels F, , 2006. Mycobacterium ulcerans disease (Buruli ulcer) in a rural hospital in Bas-Congo, Democratic Republic of Congo, 2002–2004. Am J Trop Med Hyg 75: 311314.
  9. Renzaho AM, Woods PV, Ackumey MM, Harvey SK, Kotin J, , 2007. Community-based study on knowledge, attitude and practice on the mode of transmission, prevention and treatment of the Buruli ulcer in Ga West District, Ghana. Trop Med Int Health 12: 445458.[Crossref]
  10. Sizaire V, Nackers F, Comte E, Portaels F, , 2006. Mycobacterium ulcerans infection: control, diagnosis, and treatment. Lancet Infect Dis 6: 288296.[Crossref]
  11. Webb BJ, Hauck FR, Houp E, Portaels F, , 2009. Buruli ulcer in West Africa: strategies for early detection and treatment in the antibiotic era. East Afr J Public Health 6: 144147.
  12. Ga-South Municipal Directorate, 2011. Greater Accra—Weija Municipal Demographic Characteristics. Available at: http://www.ghanadistricts.com/districts/?r=1&_=169&sa=6052. Accessed May 25, 2011.
  13. World Health Organization, Global Buruli Ulcer Initiative, 1998. Recognizing Buruli Ulcer in Your Community. Geneva: World Health Organization.
  14. Weiss MG, , 1997. Explanatory model interview catalogue (EMIC): framework for comparative study of illness. Transcult Psychiatry 34: 235263.[Crossref]
  15. Ackumey MM, Kwakye-Maclean C, Ampadu EO, de Savigny D, Weiss MG, , 2011. Health services for Buruli ulcer control: lessons from a field study in Ghana. PLoS Negl Trop Dis 5: e1187.[Crossref]
  16. Aujoulat I, Johnson C, Zinsou C, Guedenon A, Portaels F, , 2003. Psychosocial aspects of health seeking behaviours of patients with Buruli ulcer in southern Benin. Trop Med Int Health 8: 750759.[Crossref]
  17. Stienstra Y, van der Graaf WT, Asamoa K, van der Werf TS, , 2002. Beliefs and attitudes toward Buruli ulcer in Ghana. Am J Trop Med Hyg 67: 207213.
  18. Reeves DS, Finch RG, Bax RP, Davey PG, Po AL, Lingam G, Mann SG, Pringle MA, , 1999. Self-medication of antibacterials without prescription (also called ‘over-the-counter' use). A report of a Working Party of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 44: 163177.[Crossref]
  19. Huygen K, Adjei O, Affolabi D, Bretzel G, Demangel C, Fleischer B, Johnson RC, Pedrosa J, Phanzu DM, Phillips RO, Pluschke G, Siegmund V, Singh M, van der Werf TS, Wansbrough-Jones M, Portaels F, , 2009. Buruli ulcer disease: prospects for a vaccine. Med Microbiol Immunol (Berl) 198: 6977.[Crossref]
  20. Kibadi K, , 2007. Streptomycin injections for the treatment of Mycobacterium ulcerans (Buruli ulcer) in a rural health zone in the Democratic Republic of the Congo [in French]. Sante 17: 173176.
  21. Portaels F, Silva MT, Meyers WM, , 2009. Buruli ulcer. Clin Dermatol 27: 291305.[Crossref]
  22. Yemoa A, Gbenou J, Affolabi D, Moudachirou M, Bigot A, Anagonou S, Portaels F, Quetin-Leclercq J, Martin A, , 2011. Buruli ulcer: a review of in vitro tests to screen natural products for activity against Mycobacterium ulcerans . Planta Med 77: 641646.[Crossref]
  23. Grietens KP, Boock AU, Peeters H, Hausmann-Muela S, Toomer E, Ribera JM, , 2008. “It is me who endures but my family that suffers”: social isolation as a consequence of the household cost burden of Buruli ulcer free of charge hospital treatment. PLoS Negl Trop Dis 2: e321.[Crossref]
  24. Samuelsen H, , 2004. Illness transmission and proximity: local theories of causation among the Bissa in Burkina Faso. Med Anthropol 23: 89112.[Crossref]
  25. Nyika A, , 2009. The ethics of improving African traditional medical practice: scientific or African traditional research methods? Acta Trop 112 (Suppl 1): S32S36.[Crossref]
  26. Cairncross S, Braide EI, Bugri SZ, , 1996. Community participation in the eradication of guinea worm disease. Acta Trop 61: 121136.[Crossref]
  27. Addo P, Quartey M, Abass KM, Adu-Addai B, Owusu E, Okang I, Dodoo A, De Souza D, Ankrah N, Ofori-Adjei D, , 2008. In vitro susceptibility of Mycobacterium ulcerans to herbal preparations. Internet J Trop Med 4. Available at: http://www.ispub.com/journal/the_internet_journal_of_tropical_medicine/archive/volume_4_number_2_47.html. Accessed September 15, 2011.
  28. World Health Organization, 2002. WHO Traditional Medicine Strategy 2002–2005. Geneva: World Health Organization.
  29. Adusi-Poku Y, Okine LK, Hlortsi-Akakpo FK, Fleischer TC, Mensah ML, Arhin P, Agyemfra G, Dabra T, Mensah EN, , 2010. Assessing herbal medical practitioners in professional qualifying examination in Ghana, a model. Afr J Tradit Complement Altern Medicines 7: 8587.
  30. Nienhuis WA, Stienstra Y, Thompson WA, Awuah PC, Abass KM, Tuah W, Awua-Boateng NY, Ampadu EO, Siegmund V, Schouten JP, Adjei O, Bretzel G, van der Werf TS, , 2010. Antimicrobial treatment for early, limited Mycobacterium ulcerans infection: a randomised controlled trial. Lancet 375: 664672.[Crossref]
  31. Chauty A, Ardant MF, Adeye A, Euverte H, Guedenon A, Johnson C, Aubry J, Nuermberger E, Grosset J, , 2007. Promising clinical efficacy of streptomycin-rifampin combination for treatment of Buruli ulcer (Mycobacterium ulcerans disease). Antimicrob Agents Chemother 51: 40294035.[Crossref]
  32. Asase A, Oppong-Mensah G, , 2009. Traditional antimalarial phytotherapy remedies in herbal markets in southern Ghana. J Ethnopharmacol 126: 492499.[Crossref]

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  • Received : 05 Jul 2011
  • Accepted : 04 Sep 2011

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