title: Factors enhancing the control of Buruli ulcer in the Bomfa communities, Ghana.
abstract: This study examines factors that may enhance the control and holistic treatment of Buruli ulcer in an endemic area of the Ashanti Region in Ghana. A total of 189 Buruli ulcer patients from the Bomfa sub-district were treated at the Global Evangelical Mission Hospital, Apromase-Ashanti, Ghana, from January to December 2005. Diagnosis was based on clinical findings and confirmed by any two positives of Ziehl-Neelson test for acid fast bacilli, polymerase chain reaction and histopathology. Children up to age 14 made up 43.4% of the cases; male: female ratio was 3:2. The mean duration of hospitalization was 77 days and hospital stay was significantly correlated with the time spent at home with the disease prior to admission; also, 76.7% of the cases were late ulcers. Of the 189 patients, 145 (i.e. 76.7%) were treated with antibiotics and surgery which involved excision, skin grafting with or without contracture release. A follow-up survey after the introduction of the psychosocial approach recorded fewer (85) new Buruli ulcer (BU) cases of which, the majority (78.8%, 67) were nodules and only 21.2% (18) were ulcers. Health education plays a major role in the holistic treatment of BU. This paper proposes a further study in other endemic areas on the treatment of BU with emphasis on psychosocial approach for holistic treatment.
authors.affiliation: Reconstructive Plastic Surgery and Burns Unit, Komfo Anokye Teaching Hospital, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. pimagben@yahoo.com
authors.forename: Pius
authors.initials: P
authors.lastname: Agbenorku
authors.forename: Margaret
authors.initials: M
authors.lastname: Agbenorku
authors.forename: Adela
authors.initials: A
authors.lastname: Amankwa
authors.forename: Lawrence
authors.initials: L
authors.lastname: Tuuli
authors.forename: Paul
authors.initials: P
authors.lastname: Saunderson
mesh_terms: D000293:Adolescent; D000328:Adult; D054312:Buruli Ulcer / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019911:Mycobacterium ulcerans / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012423:Rural Health; D013997:Time Factors; D016896:Treatment Outcome; D014871:Water Microbiology; D055815:Young Adult