Persisting social participation restrictions among former Buruli ulcer patients in Ghana and Benin.
BACKGROUND
Buruli ulcer may induce severe disabilities impacting on a person's well-being and quality of life. Information about long-term disabilities and participation restrictions is scanty. The objective of this study was to gain insight into participation restrictions among former Buruli ulcer patients in Ghana and Benin.


METHODS
In this cross-sectional study, former Buruli ulcer patients were interviewed using the Participation Scale, the Buruli Ulcer Functional Limitation Score to measure functional limitations, and the Explanatory Model Interview Catalogue to measure perceived stigma. Healthy community controls were also interviewed using the Participation Scale. Trained native interviewers conducted the interviews. Former Buruli ulcer patients were eligible for inclusion if they had been treated between 2005 and 2011, had ended treatment at least 3 months before the interview, and were at least 15 years of age.


RESULTS
In total, 143 former Buruli ulcer patients and 106 community controls from Ghana and Benin were included in the study. Participation restrictions were experienced by 67 former patients (median score, 30, IQR; 23;43) while 76 participated in social life without problems (median score 5, IQR; 2;9). Most restrictions encountered related to employment. Linear regression showed being female, perceived stigma, functional limitations, and larger lesions (category II) as predictors of more participation restrictions.


CONCLUSIONS
Persisting participation restrictions were experienced by former BU patients in Ghana and Benin. Most important predictors of participation restrictions were being female, perceived stigma, functional limitations and larger lesions.
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Janine
J
de Zeeuw
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Till F
TF
Omansen
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Marlies
M
Douwstra
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands; Programme National de Lutte contre la Lèpre et L'Ulcère de Buruli, Ministère de la Santé, Cotonou, République du Bénin.
Yves T
YT
Barogui
Programme National de Lutte contre la Lèpre et L'Ulcère de Buruli, Ministère de la Santé, Cotonou, République du Bénin.
Chantal
C
Agossadou
Programme National de Lutte contre la Lèpre et L'Ulcère de Buruli, Ministère de la Santé, Cotonou, République du Bénin.
Ghislain E
GE
Sopoh
Kwame Nkrumah University of Science and Technology, School of Medical Sciences, Department of Medicine, Kumasi, Ghana.
Richard O
RO
Phillips
Fondation Raoul Follereau, Cotonou, République du Bénin.
Christian
C
Johnson
Agogo Presbyterian Hospital, Agogo, Ghana.
K Mohammed
KM
Abass
American Leprosy Missions, Greenville, South Carolina, United States of America.
Paul
P
Saunderson
University of Groningen, University Medical Center Groningen, Department of Rehabilitation and Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands.
Pieter U
PU
Dijkstra
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Tjip S
TS
van der Werf
University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
Ymkje
Y
Stienstra
Ymkje
Y
Stientstra
D000293:Adolescent; D000328:Adult; D001541:Benin / Q000453:epidemiology; D054312:Buruli Ulcer / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D016014:Linear Models; D008297:Male; D012737:Sex Factors; D058992:Social Participation / Q000523:psychology*; D057545:Social Stigma; D055815:Young Adult