Assessment of health care workers’ knowledge, attitude and risk perception of Buruli ulcer disease in Southern Nigeria

Ekeke, Ngozi; Meka, Anthony O.; Chukwu, Joseph N.; Nwafor, Charles C.; Alphonsus, Chukwuka; Mbah, Obinna; Madichie, Nelson O.; Aduh, Ufuoma; Ogbeifo, Matthew; IseOluwa-Adelokiki, Bola Olubakin; Edochie, Joseph E.; Ushaka, Joseph; Ukwaja, Kingsley Nnanna

doi:10.1093/trstmh/trx049

Cited by 5 publications

(5 citation statements)

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“…In this study, less than half of the respondents knew that these lesions were due to germs/infection; more than two-thirds of community respondents and a third of health care workers indicated that it can be caused by witchcraft/poison. This wrong knowledge of the causes of these skin NTDs is consistent with previous findings for LF and BU; and may lead affected persons to consult traditional medical practitioners and faith healers for help [16][17][20][21][22]. Thus, among the respondents, belief in the efficacy of herbal remedies and faith healing remains a consistent theme in the community.…”

Section: Discussionsupporting

confidence: 81%

“…Despite the availability of primary health care centres, the community respondents indicated that they would not go there first due to high costs, belief they would get better services elsewhere, lack of trust in the health system and poor attitude of the staff. Thus, the understanding that financial and structural barriers are also an impediment to early access of skin NTD services in our setting are in keeping with other studies from Nigeria and elsewhere [15][16]. Although the provision of free medication and wound care packs should address most of the direct cost issues, patient and community education will be needed to address beliefs around causation and transmission, strengthen self-care practices and promote the inclusion of family and social support systems.…”

Section: Discussionsupporting

confidence: 54%

“…Community perceptions of causation of NTDs may play an important role in access to or utilization of health services [15][16]. One of the key guiding principles of the WHO African Region Strategic Plan for NTDs is empowerment of people and communities through the involvement of populations affected by or at risk of NTDs in control interventions [7].…”

Section: Introductionmentioning

confidence: 99%

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Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

Ukwaja

Alphonsus²,

Eze³

et al. 2020

PLoS Negl Trop Dis

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Background There is a dearth of experience in and evidence for cost-effective integrated communitybased management of skin neglected tropical diseases (NTDs). The objective of this study was to assess the knowledge, attitude and care-seeking practices including self-care with a view to introducing appropriate community-based interventions for skin NTDs in an endemic setting in Southern Nigeria. Methods/Principal findings This exploratory study adopted a mixed-methods design consisting of cross-sectional surveys of community members and health workers using interviewer-administered questionnaires; and focus group discussions (FGDs) with community members, health care workers and patients with NTDs in Anambra State, Nigeria. The survey was completed by 353 community members (61.8% female) and 15 health care workers (100.0% female). A total of 52 individuals participated in six FGDs. Of the community members, 236 (66.9%) had heard or seen a case of leprosy; 324 (91.8%) and 131 (37.5%) had heard or seen a case of Buruli ulcer and lymphatic filariasis, respectively. Again, 213 (60.3%) of the respondents reported that the diseases were caused by witchcraft or curse. As regards prevention, 241 (68.3%) suggested avoiding handshake with affected persons. Up to 223 (63.2%) of respondents strongly agreed to the seriousness of skin NTDs in their community. Meanwhile, 272 (77.1%) of the respondents believed that the transmission of these skin NTDs can be prevented. Furthermore, 324 (91.7%) desired active community engagement for control of skin NTDs. Regarding community care seeking practices, 197 (55.8%) would first visit the health centre/hospital, followed by 91 (25.8%) traditional healer/herbalist and 35 (9.9%) pharmacy/ patent medicine vendor if they develop a skin NTD. Overall, 332 (94.1%) of respondents expressed interest in being taught self-care practices for skin NTDs. Out of 15 healthcare workers, 13 (86.7%) were able to correctly diagnose two of these skin NTDs and 10 (66.7%) would encourage patients to practice self-care. Prominent themes in the FGDs were belief PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

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Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

Ukwaja

Alphonsus²,

Eze³

et al. 2020

PLoS Negl Trop Dis

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“…We also found that ethnicity was an independent predictor of knowledge of BUD with patients belonging to the “other” smaller ethnic groups (besides the major Igbo and Yoruba ethnic groups) in the study setting had poorer knowledge of BUD. These communities and the health care workers serving them will benefit from further targeted educational programmes in order to improve their knowledge of the disease23.…”

Section: Discussionmentioning

confidence: 99%

Assessment of community knowledge, attitude, and stigma of Buruli ulcer disease in Southern Nigeria

Nwafor¹,

Meka²,

Chukwu³

et al. 2019

Afr H. Sci.

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BackgroundPoor knowledge can influence timely care-seeking among persons with Buruli ulcer disease (BUD).ObjectivesTo assess community knowledge, attitude and stigma towards persons with BUD in endemic settings of Southern Nigeria.MethodsThis was a cross-sectional survey conducted among adult community members in four States of Southern Nigeria. A semi-structured interviewer-administered questionnaire was administered to all participants.ResultsOf 491 adults who completed the survey, 315 (64.2%) belonged to the ≤40 years age group, 257 (52.3%) were males and 415 (84.5%) had some formal education. The overall mean (SD) knowledge score was 5.5±2.3 (maximum 10). Only 172 (35.0%) of the participants had a good knowledge of BUD. A total of 327 (66.6%) considered BUD as a very serious illness. Also, there was a high-level of stigma against BUD patients; 372 (75.8%) of the participants felt compassion for and desire to help them, 77 (15.7%) felt compassion but tended to stay away from them, and 53 (10.8%) feared them because they may infect them with the disease. Having a formal education and ethnicity were independent predictors of good knowledge of BUD.ConclusionThere is poor community knowledge of BUD in endemic settings of Southern Nigeria which influenced the attitude and perceptions of community members towards persons with BUD

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“…In such places, PCR confirmation is also often unavailable. Cross-sectional surveys among frontline healthcare providers have demonstrated that knowledge of BU diagnosis and management can be low in endemic areas 21,22 . Studies on clinical diagnoses made at primary health centres also show that the majority of presumptive clinical diagnoses of BU without PCR have different aetiology 7,23 .…”

Section: Passive Surveillance Clinical Diagnosis and Data Reportingmentioning

confidence: 99%

Methods and Approaches for Buruli Ulcer Surveillance in Africa: Lessons Learnt and Future Directions

Timothy

Pullan

Yotsu

2021

Methods in Molecular Biology

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Over 95% of the global burden of Buruli ulcer disease (BU) caused by Mycobacterium ulcerans occurs in equatorial Africa. National and sub-national programmes have implemented various approaches to improve detection and reporting of incident cases over recent decades.Regional incidence rates are currently in decline, however, surveillance targets outlined in 2012 by WHO have been missed and detection bias may contribute to these trends. In light of the new 2030 NTD roadmap and disease-specific targets, BU programmes are required to strengthen case detection and begin a transition towards integration with other skin-NTDs. This transition comes with new opportunities to enhance existing BU surveillance systems and develop novel approaches for implementation and evaluationIn this review, we present a breakdown and assessment of the methods and approaches that have been the pillars of BU surveillance systems in Africa i) Passive case detection ii) Data systems iii) Clinical training iv) Active case finding v) Burden estimation vi) Laboratory confirmation pathways. We discuss successes, challenges and relevant cases studies before highlighting opportunities for future development and evaluation including i) Novel data collection tools ii) Risk-based surveillance iii) Integrated skin-NTD surveillance. We draw on both experience and available literature to critically evaluate methods of BU surveillance in Africa and highlight new approaches to help achieve 2030 roadmap targets.

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Assessment of health care workers’ knowledge, attitude and risk perception of Buruli ulcer disease in Southern Nigeria

Abstract: Health care workers in endemic settings of Nigeria have poor knowledge of and poor risk perception of BU disease. Training of health care workers is recommended to address the identified gaps to ensure earlier diagnosis and referral to specialist centres.

Cited by 5 publications

References 15 publications

Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

Investigating barriers and challenges to the integrated management of neglected tropical skin diseases in an endemic setting in Nigeria

Assessment of community knowledge, attitude, and stigma of Buruli ulcer disease in Southern Nigeria

Methods and Approaches for Buruli Ulcer Surveillance in Africa: Lessons Learnt and Future Directions

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