Experiences of Pain and Expectations for Its Treatment Among Former Buruli Ulcer Patients

Rebecca J. Woolley University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

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Anita Velink University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

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Richard O. Phillips Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

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William A. Thompson Agogo Presbyterian Hospital, Agogo, Ghana.

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K. Mohammed Abass Agogo Presbyterian Hospital, Agogo, Ghana.

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Tjip S. van der Werf Department of Internal Medicine/Infectious Diseases Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

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Janine de Zeeuw Department of Internal Medicine/Infectious Diseases Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

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Ymkje Stienstra Department of Internal Medicine/Infectious Diseases Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

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DOI:
https://doi.org/10.4269/ajtmh.16-0419
Volume/Issue:
Volume 95: Issue 5
Page(s):
1011–1015
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Buruli ulcer (BU) is one of the 17 neglected tropical diseases for which the World Health Organization has adopted resolutions to improve treatment. BU was previously described as a relatively painless condition; however, recent research has indicated that some patients experience substantial pain. The objective of this study was to explore patients' experiences of pain and their expectations for its treatment. Semistructured interviews were conducted in a BU-endemic region of Ghana. Interviews were held with former BU patients (N = 20) and community controls (N = 19). Former patients were asked about BU-related pain and their expectations for its treatment. The interviews were conducted in October 2014, and were audiotaped, translated and transcribed into English, and then qualitatively analyzed. Of the 20 former BU patients interviewed, 19 (95%) reported experiencing pain, with patients reporting pain as a consequence of the ulcer and wound management. Some participants expressed pain through crying, whereas others did not openly express pain, sometimes because they feared the repercussions of doing so. Patients wanted to receive pain relief; however, many were unable to name a medication. Nonpharmaceutical options were cited as being an alternative. Many BU patients experience pain; however, former patients and community members alike appear to have a limited knowledge about available pain relief. A low-cost alternative to medication may be the use of nonpharmaceutical means for pain relief. Routine pain assessment may reduce patients' fear and unwillingness to express pain. Awareness of such issues will be valuable when implementing a BU pain relief guideline.

Author Notes

* Address correspondence to Ymkje Stienstra, Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands. E-mail: y.stienstra@umcg.nl

Financial support: This work was supported by the Gratama foundation and the Buruli Ulcer Groningen (BUG) foundation. Ymkje Stienstra received a VENI grant from the Dutch Organization for Scientific Research.

Authors' addresses: Rebecca J. Woolley, Anita Velink, Tjip S. van der Werf, Janine de Zeeuw, and Ymkje Stienstra, Department of Internal Medicine/Infectious Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands, E-mails: r.j.woolley@student.rug.nl, a.velink@umcg.nl, t.s.van.der.werf@umcg.nl, j.de.zeeuw@umcg.nl, and y.stienstra@umcg.nl. Richard O. Phillips, Department of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana, and School of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana, E-mail: rodamephillips@gmail.com. William A. Thompson and K. Mohammed Abass, Buruli Ulcer Clinic, Agogo Presbyterian Hospital, Agogo, Ghana, E-mails: wnat111@yahoo.com and abass@agogopresbyhospital.org.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2016
Received:
24 May 2016
|
Accepted:
07 Aug 2016
|
Published Online:
02 Nov 2016
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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