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RELIABILITY AND VALIDITY OF THE BURULI ULCER FUNCTIONAL LIMITATION SCORE QUESTIONNAIRE

YMKJE STIENSTRADepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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PIETER U. DIJKSTRADepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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MARIEKE J. VAN WEZELDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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MARGIJSKE H. G. VAN ROESTDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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MICHIEL BEETSDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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IJSBRAND ZIJLSTRADepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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R. CHRISTIAN JOHNSONDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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EDWIN O. AMPADUDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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JULES GBOVIDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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CLAUDE ZINSOUDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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SAMUEL ETUAFULDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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ERASMUS Y. KLUTSEDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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WINETTE T. A. VAN DER GRAAFDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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TJIP S. VAN DER WERFDepartment of Internal Medicine and Department of Rehabilitation, Groningen University Hospital,Groningen, The Netherlands, Programme National de Lutte Contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin; Ministry of Health, National Buruli Ulcer Control Program, Accra, Ghana; Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin; Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin; Saint Martin’s Catholic Hospital, Agroyesum, Ghana; Dunkwa Governmental Hospital, Dunkwa, Ghana

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The reliability and validity of the earlier developed Buruli ulcer functional limitation score (BUFLS) questionnaire was assessed. Of 638 former Buruli ulcer patients (of 678 individuals examined), sufficient items on daily activities (≥ 13 of the 19) were applicable to calculate a score. To determine the validity, the functional limitation scores of the 638 individuals were compared with the global impression of the limitations, range of motion (ROM), and the social impact (change of occupation or education) of Buruli ulcer. To determine inter-observer reliability, the functional limitation score was reassessed in 107 participants within one and three weeks after the first interview by another interviewer and interpreter. Both global impression and ROM correlated well with the functional limitation scores (ρ = 0.66 and ρ = 0.61). The inter-observer reliability of 107 participants as measured by an intra-class correlation coefficient of 0.86 was very good. The functional limitation scores measured in the second assessment were significantly higher than in the first assessment. This should be taken into account when the functional limitation score is used for the individual patient. The BUFLS can be used as for between group comparisons of endpoints in clinical trials and in the planning of resources.

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