Beliefs, attitudes and practices towards scabies in central Ghana

Abstract

Background Scabies commonly affects poor populations in low-middle-income countries. The WHO has advocated for country-driven and country-owned control strategies. Knowledge of context specific issues will be important for design and implementation of scabies control interventions. We aimed to assess beliefs, attitudes and practices towards scabies in central Ghana. Methodology/Principal findings Data was collected via semi-structured questionnaires for people who had active scabies or scabies in the past year and people who never had scabies in the past. The questionnaire covered several domains: knowledge about the causes and risk factors; perceptions towards stigmatisation and consequences of scabies in daily life; and treatment practices. Out of 128 participants, 67 were in the (former) scabies group and had a mean age of 32.3 ± 15.6 years. Overall scabies group participants less often indicated a factor to predispose to scabies than community controls; only ‘family/friends contacts’ was more often mentioned in the scabies group. Scabies causation was attributed to poor hygiene, traditional beliefs, heredity and drinking water. Individuals with scabies delay care seeking (median time from symptom onset to visiting the health centre was 21 [14 – 30] days) and this delay is enhanced by their beliefs (like witchcraft and curses) and a perception of limited disease severity. Compared to past scabies participants in the dermatology clinic, participants with past scabies in the community tended to have a longer delay (median [IQR] 30 [14–48.8] vs 14 [9.5–30] days, p = 0.002). Scabies was associated with health consequences, stigma, and loss of productivity. Conclusion/Significance Early diagnosis and effective treatment of scabies can lead to persons less frequently associating scabies with witchcraft and/ or curses. There is the need to enhance health education to promote early care seeking, enhance knowledge of communities on impact and dispel negative perceptions about scabies in Ghana.

Stigma experiences, effects and coping among individuals affected by Buruli ulcer and yaws in Ghana

“…Stigma and supernatural explanations of disease causation (such as witchcraft and curses) are usually linked to diseases which are difficult to cure or chronic and in which causation is difficult to explain [ 20 ]. However, in a previous study in Ghana, some 13% of participants believed that yaws was caused by supernatural forces such as witchcraft, curses or a punishment from god and this belief was not associated with gender, religion or ethnicity [ 19 ].…”

“…Studies of skin NTDs suggest that the diseases may be perceived as symbols of disgrace within some social contexts, inhibiting social participation and leading to socio-economic hardship for affected people [ 17 ]. Traditional beliefs in witchcraft, curses, or evil spirits have been linked to the stigma experiences in leprosy, Buruli ulcer [ 18 ], yaws [ 19 ] and scabies [ 20 ]. In podoconiosis, beliefs about the hereditary nature of the disease are associated with stigma reported by affected individuals [ 21 ].…”

Prevalence and determinants of impetigo in Ghana: a cross-sectional study

“…They affect individuals of all ages and from all socio-economic backgrounds [ 1 – 3 ]. The detrimental effects of skin diseases on health include physical, psychologic and socio-economic impact on affected persons and their families [ 4 – 8 ].…”

Traditional healers' perception on scabies causation and management in Ghana

“…There is a paucity of data on the extent to which people in endemic regions turn to THs specifically for the treatment of scabies. Most individuals affected by scabies in Ghana tend to seek care from the formal health system; however, the use of local herbal remedies and the services of TH have also been reported [7]. In a previous study from Guinea Bissau, 9.3% of respondents reported a TH as preferred care provider if a household member had scabies with 10.7% identifying 'trust in traditional medicine' as a reason for their choice of treatment [20].…”

“…The disease burden of scabies is high, not only consisting of physical complaints but also psychological and social consequences [5,20,21]. Scabies remains an underdiagnosed condition at the clinical and public health level in Ghana and as of today, little is known about the role of THs in the management of scabies [7]. The perceptions of Ghanaian THs on scabies have not been investigated before.…”