Perceptions on the effectiveness of treatment and the timeline of Buruli ulcer influence pre-hospital delay reported by healthy individuals.
BACKGROUND
Delay in seeking treatment at the hospital is a major challenge in current Buruli ulcer control; it is associated with severe sequelae and functional limitations. Choosing alternative treatment and psychological, social and practical factors appear to influence delay. Objectives were to determine potential predictors for pre-hospital delay with Leventhal's commonsense model of illness representations, and to explore whether the type of available dominant treatment modality influenced individuals' perceptions about BU, and therefore, influenced pre-hospital delay.


METHODS
130 healthy individuals aged >18 years, living in BU-endemic areas in Benin without any history of BU were included in this cross-sectional study. Sixty four participants from areas where surgery was the dominant treatment and sixty six participants from areas where antibiotic treatment was the dominant treatment modality were recruited. Using a semi-structured interview we measured illness perceptions (IPQ-R), knowledge about BU, background variables and estimated pre-hospital delay.


RESULTS
The individual characteristics 'effectiveness of treatment' and 'timeline acute-chronic' showed the strongest association with pre-hospital delay. No differences were found between regions where surgery was the dominant treatment and regions where antibiotics were the dominant treatment modality.


CONCLUSIONS
Individual characteristics, not anticipated treatment modality appeared predictors of pre-hospital delay.
University of Groningen, University Medical Center Groningen, Department of Health Sciences, Groningen, The Netherlands. m.alferink@umcg.nl
Marike
M
Alferink
Tjip S
TS
van der Werf
Ghislain E
GE
Sopoh
Didier C
DC
Agossadou
Yves T
YT
Barogui
Frederic
F
Assouto
Chantal
C
Agossadou
Roy E
RE
Stewart
Ymkje
Y
Stienstra
Adelita V
AV
Ranchor
D000328:Adult; D001541:Benin; D054312:Buruli Ulcer / Q000188:drug therapy* / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D013997:Time Factors; D055815:Young Adult