Experiences of Buruli Ulcer Patients with the Anesvad Intervention in Endemic Districts in Ghana

Abstract

INTRODUCTION: Buruli ulcer (BU) is a neglected tropical disease that affects mainly the skin, tissues and, in some instances, the bones. The disease is caused by Mycobacterium ulcerans, an environmental pathogen in the same family as the bacteria that causes leprosy and tuberculosis. After tuberculosis and leprosy, BU is the third most common Mycobacterium infection. In Ghana, the ANESVAD Intervention is one of the key health interventions that have been implemented to control the morbidity of BU and reduce the risk of disability associated with it. Though the intervention also took care of Leprosy and Yaws patients, this study only explored the experiences of buruli ulcer patients with the ANESVAD Intervention in three ANESVAD sponsored district. The experiences of implementers of the intervention were also explored to get broader understanding of the intervention and the experiences buruli ulcer patients had with it. METHODOLOGY: This was a qualitative study that used in-depth interviews to explore the experiences of nine buruli ulcer patients and nine key informant interviews of program implementers in addition to get a broader understanding of the ANESVAD Intervention. Purposive and convenience sampling were used to select participants and Thematic content analysis was used to analyze data with the aid of NVivo 10 software. RESULTS: Buruli ulcer patients before the ANESVAD Intervention resorted to herbs to treat their wounds due to their limited knowledge on the cause and treatment of the disease. For some patients, financial difficulties hindered their ability to seek for treatment at the hospital. During the implementation of the intervention, patients were educated to understand the cause of the disease and its treatment. The intervention provided free antibiotics for patients, transportation to the health facilities and provided logistics for health workers to dress the wounds of the patients. The implementers gained in-depth knowledge on the disease and were provided with financial support and logistics to take care of the needs of the patients. The implementers partnered with agencies such as the media, NGOs, GES, KCCR among others during implementation of the intervention. The commitment of patients, implementers and other stakeholders made the implementation a success. Delayed funds, relapse of patients and drug wastage due to expiration were some challenges of the ANESVAD Intervention. CONCLUSION: From this study, buruli ulcer patients had a positive experience with the ANESVAD Intervention. Patients were enlightened on buruli ulcer and other NTDs, had treatment, changed their health seeking behavior and also reduced stigmatization against them.