title: Former Buruli Ulcer Patients' Experiences and Wishes May Serve as a Guide to Further Improve Buruli Ulcer Management.
abstract: BACKGROUND
  Buruli ulcer (BU), caused by Mycobacterium ulcerans, is a neglected tropical disease frequently leading to permanent disabilities. The ulcers are treated with rifampicin and streptomycin, wound care and, if necessary surgical intervention. Professionals have exclusively shaped the research agenda concerning management and control, while patients' perspective on priorities and preferences have not explicitly been explored or addressed.
  
  
  RESULTS
  To get insight into patient perception of the management and control of Buruli ulcer a mixed methods research design was applied with a questionnaire and focus group discussions among former BU patients. Data collection was obtained in collaboration with a local team of native speakers in Ghana. A questionnaire was completed by 60 former patients and four focus group discussions were conducted with eight participants per group. Former patients positively evaluated both the effectiveness of the treatment and the financial contribution received for the travel costs to the hospitals. Pain experienced during treatment procedures, in particular wound care and the streptomycin injections, and the side-effects of the treatment were negatively evaluated. Former patients considered the development of preventive measures and knowledge on the transmission as priorities. Additionally, former patients asked for improved accessibility of health services, counselling and economic support.
  
  
  CONCLUSIONS
  These findings can be used to improve clinical management and to guide the international research agenda.
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Anita
authors.initials: A
authors.lastname: Velink
authors.affiliation: University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Woolley
authors.affiliation: Kwame Nkrumah University of Science and Technology, School of Medical Sciences, Department of Medicine, Kumasi, Ghana.
authors.forename: Richard O
authors.initials: RO
authors.lastname: Phillips
authors.affiliation: Agogo Presbyterian Hospital, Agogo, Ghana.
authors.forename: Kabiru M
authors.initials: KM
authors.lastname: Abass
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
authors.forename: Tjip S
authors.initials: TS
authors.lastname: van der Werf
authors.affiliation: President and founder of Buruli ulcer Victims Aid (BUVA) foundation, Kumasi, Ghana.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Agumah
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.|University of Groningen, Institute for Medical Education, Learning Community Global Health, Groningen, The Netherlands.
authors.forename: Janine
authors.initials: J
authors.lastname: de Zeeuw
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
authors.forename: Sandor
authors.initials: S
authors.lastname: Klis
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Internal Medicine/Infectious Diseases, Groningen, The Netherlands.
authors.forename: Ymkje
authors.identifier: http://orcid.org/0000-0002-8844-8859
authors.initials: Y
authors.lastname: Stienstra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D054312:Buruli Ulcer / Q000188:drug therapy*; D005260:Female; D017144:Focus Groups; D005869:Ghana; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D019911:Mycobacterium ulcerans; D057240:Patient Preference; D012293:Rifampin / Q000009:adverse effects / Q000627:therapeutic use*; D013307:Streptomycin / Q000009:adverse effects / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D012293:Rifampin; D013307:Streptomycin