Factors Influencing the Health Seeking Behaviour of Buruli Ulcer Patients in Two Buruli Ulcer Endemic Districts in the Brong-Ahafo Region

Abstract

Background: Buruli ulcer (BU) is commonly found in waterlogged areas, and its prevalence is high among farmers, especially rice farmers, illegal miners (galamsey) and children who engage in fishing activities (Huygen et al., 2013). Public health interventions for all diseases including Buruli ulcer, seek to persuade cases to report to the health facility early, as this will potentially reduce the cost of treatment and prevent disabilities. Unfortunately, most BU affected individuals tend to seek treatment at the late stages of the disease, which leaves them incapacitated and with disability. The study seeks to determine factors influencing the health seeking behaviour of Buruli ulcer patients in Dormaa Municipality and Asutifi South District Health Directorate in the Brong Ahafo region. Method: A community- based cross-sectional study involving 222 BU patients was conducted in Asutifi south district and Dormaa municipal. Study participants were purposively recruited into the study. A structured questionnaire was used to collect data over a 6-week period from May to June 2018. Stata version 15.0 software was used for data analysis. Descriptive statistics were used to summarize data. Pearson‟s chi-square test was performed to determine the association between the health system factors, socio-cultural factors and demographic factors and the health-seeking behaviour where significantly associated variables were put into logistic regression models and analysis to determine the strength of the associations at 95% confidence interval with p-value of <0.05 considered to be significant. Results: All the study participants were laboratory confirmed BU cases with 150 (67.6%) having high-level knowledge in BU, this culminated in the association between knowledge of BU and the hospital care (p=<0.001). None of the socio-demographic factors was significantly associated (p<0.05) with the use of hospital care. The odds of seeking treatment from health facility was 12.7 times higher among respondents who mentioned drug availability compared to respondents who said drug not available (COR=12. 71, 95% CI=6.66-24.67, p=<0.001). None of the socio-cultural factors (traditional belief towards BU, kind of belief, why or not herbalist treatment site motivated by, family support, support provider and BU patient socialization) was associated with the use of hospital care (p>0.05). Conclusion: The choice of hospital care among the study participants was high. However, knowledge of BU was the only variable which was statistically associated with the choice of hospital care.