title: Pain Associated with Wound Care Treatment among Buruli Ulcer Patients from Ghana and Benin.
abstract: Buruli ulcer (BU) is a necrotizing skin disease caused by Mycobacterium ulcerans. People living in remote areas in tropical Sub Saharan Africa are mostly affected. Wound care is an important component of BU management; this often needs to be extended for months after the initial antibiotic treatment. BU is reported in the literature as being painless, however clinical observations revealed that some patients experienced pain during wound care. This was the first study on pain intensity during and after wound care in BU patients and factors associated with pain. In Ghana and Benin, 52 BU patients above 5 years of age and their relatives were included between December 2012 and May 2014. Information on pain intensity during and after wound care was obtained during two consecutive weeks using the Wong-Baker Pain Scale. Median pain intensity during wound care was in the lower range (Mdn = 2, CV = 1), but severe pain (score > 6) was reported in nearly 30% of the patients. Nevertheless, only one patient received pain medication. Pain declined over time to low scores 2 hours after treatment. Factors associated with higher self-reported pain scores were; male gender, fear prior to treatment, pain during the night prior to treatment, and pain caused by cleaning the wound. The general idea that BU is painless is incorrect for the wound care procedure. This procedural pain deserves attention and appropriate intervention.
authors.affiliation: Department of Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.
authors.forename: Marike
authors.initials: M
authors.lastname: Alferink
authors.affiliation: Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Janine
authors.initials: J
authors.lastname: de Zeeuw
authors.affiliation: Programme de Lutte Contre la Lèpre et l'Ulcère de Buruli, Ministries of Health, Cotonou, Bénin.
authors.forename: Ghislain
authors.initials: G
authors.lastname: Sopoh
authors.affiliation: Programme de Lutte Contre la Lèpre et l'Ulcère de Buruli, Ministries of Health, Cotonou, Bénin.
authors.forename: Chantal
authors.initials: C
authors.lastname: Agossadou
authors.affiliation: Agogo Presbyterian Hospital, Agogo, Ghana.
authors.forename: Karibu M
authors.initials: KM
authors.lastname: Abass
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Richard O
authors.initials: RO
authors.lastname: Phillips
authors.affiliation: Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Susanne
authors.initials: S
authors.lastname: Loth
authors.affiliation: Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Emma
authors.initials: E
authors.lastname: Jutten
authors.affiliation: Programme de Lutte Contre la Lèpre et l'Ulcère de Buruli, Ministries of Health, Cotonou, Bénin.
authors.forename: Yves T
authors.initials: YT
authors.lastname: Barogui
authors.affiliation: Department of Public Health, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.
authors.forename: Roy E
authors.initials: RE
authors.lastname: Stewart
authors.affiliation: Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Tjip S
authors.initials: TS
authors.lastname: van der Werf
authors.affiliation: Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
authors.forename: Ymkje
authors.initials: Y
authors.lastname: Stienstra
authors.affiliation: Department of Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001541:Benin; D054312:Buruli Ulcer / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005869:Ghana; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents