Spatial Patterns of Mycobacterium Ulcerans Infection (Buruli Ulcer) In the Akwapim South District

Abstract

This study is about the spatial patterns of the Mycobacterium ulcerans infections (Buruli ulcer) in the Akwapim South district. The Triangle of Human Ecology model was used to account for the observed spatial patterns of the disease. The spatial distribution of the disease was mapped through the residential addresses of the patients as shown in the district medical records. The endemic communities were stratified into three segments namely the high, low and nonendemic areas or zones. The settlements for the study were then randomly selected from each stratum. This was proceeded by the selection of the target population according to the research objectives. Primary data were collected from three sources namely the household heads, Buruli ulcer patients and the health personnel (including the District Director of Health Services). Besides this, direct personal observation of the natural environment as well as interviews with certain individuals yielded primary information this study. The study looked out for the magnitude of the problem, the underlying factors of the spatial patterns and the socio-economic impact on the populace. Children were found to be more vulnerable to infection than adults. Thus prevalence decreased with age with an overall slight female predominance in incidence. It was further discovered that the quality of the natural environment to a very large extent influenced the spatial variations of the disease. It was more prevalent along watercourses and low-lying areas but non-existent on high grounds with better drainage. This confirms the research proposition and findings elsewhere that the disease is more prevalent along water bodies. Low patronage of health care facilities influenced by the socio-economic status of the respondents and the skewed distribution of such facilities was observed to have contributed to the incidence of the disease in the communities. For it is believed that accessing a health facility for advice earlier could have lessened the scourge. Restricted access to health facilities thus varies from place to place and this reflects in the spatial patterns of the disease. The disease, it was discovered had adversely affected the socio-economic lives of the patients themselves and their families due to prolonged treatment. This supports the fact by some scholars that prolonged treatment or hospitalization can bring untold hardships to both patients and their families. Efforts by the health authorities in the district to check the spread of the disease were thwarted resource constraints. The study concludes that the disease is a socio-economic problem, thus recommendations have been made, which if implemented will reduce incidence in the future.