Experiences of Pain and Expectations for Its Treatment Among Former Buruli Ulcer Patients

Abstract

Abstract. Buruli ulcer (BU) is one of the 17 neglected tropical diseases for which the World Health Organization has adopted resolutions to improve treatment. BU was previously described as a relatively painless condition; however, recent research has indicated that some patients experience substantial pain. The objective of this study was to explore patients' experiences of pain and their expectations for its treatment. Semistructured interviews were conducted in a BU-endemic region of Ghana. Interviews were held with former BU patients (N = 20) and community controls (N = 19). Former patients were asked about BU-related pain and their expectations for its treatment. The interviews were conducted in October 2014, and were audiotaped, translated and transcribed into English, and then qualitatively analyzed. Of the 20 former BU patients interviewed, 19 (95%) reported experiencing pain, with patients reporting pain as a consequence of the ulcer and wound management. Some participants expressed pain through crying, whereas others did not openly express pain, sometimes because they feared the repercussions of doing so. Patients wanted to receive pain relief; however, many were unable to name a medication. Nonpharmaceutical options were cited as being an alternative. Many BU patients experience pain; however, former patients and community members alike appear to have a limited knowledge about available pain relief. A low-cost alternative to medication may be the use of nonpharmaceutical means for pain relief. Routine pain assessment may reduce patients' fear and unwillingness to express pain. Awareness of such issues will be valuable when implementing a BU pain relief guideline.

Accounting for variation in and overuse of antibiotics among humans

“…Examples include: (i), in China, the actions of antibiotics and nonsteroidal anti‐inflammatory drugs are often conflated, as Xiaoyanyao , drugs that can eliminate inflammation, [ 77–80 ] leading to antibiotic use for conditions with self‐limited inflammation; (ii), in Nigeria, women are increasingly using antibiotics to reduce menstrual problems (cramps, heavy flow, headaches, pimples/acne, moodiness, tender breasts, backache, joint and muscle pain) and to prevent “infections” from feminine sanitary products [ 81,82 ] ; (iii), in Thailand, tetracycline is commonly used for women's “uterus” complaints, termed moot luuk , manifesting as vaginal discharge and pelvic pain [ 83,84 ] ; and (iv), a common (world‐wide) practice is self‐treatment of wounds with crushed antibiotic capsules to dry them, reduce pain, and treat infection. [ 76,85–89 ]…”

Buruli Ulcer: a Review of the Current Knowledge

“…Good wound management is required not only for faster and sequelae-free epithelialization of ulcers but also for increased quality of life of patients. BU lesions were previously noticed to be associated with no or limited pain, but recent studies have revealed that many patients actually experience pain after the start of treatment [ 72 , 95 , 96 ]. This pain is most felt during wound dressing change when in many settings, gauze is the only dressing type being used [ 97 ].…”

Systematic Review Exploring the Impact of Socio-Cultural Factors on Pain Management Approaches in Sub- Saharan Africa

“…Examination of the 24 studies included in this systematic review identified that five studies were conducted in Nigeria (Alexander et al,2015, Arinze et al, 2018, Igwesi-Chidobe et al, 2017, Olaogun et al, 2008, Suleiman et al, 2016), a further five studies were from Ghana (Aziato et al, 2017, Aziato & Adejumo, 2014, Aziato et al 2016, Aziato et al, 2017, Woolley et al, 2016), four from South Africa (Beck, 2000, Lourens et al, 2020, Nortje & Albertyn, 2015, Ratshikana-Moloko et al, 2020), two from studies were from Ethiopia (Bishaw et al, 2020, Eshete et al, 2019), two from SSA (Clancy, 2014, Harding, 2003), and one study from from Ghana & Benin (de Zeeuw et al, 2015), Rwanda (Johnson et al, 2015), Uganda (Nabukenya et al, 2015), Kenya (Onsongo, 2020), Zimbabwe (Sonquishe & Levy, 1990), and Cameroon (Young et al, 2018).…”