Reliability and Validity of the Buruli Ulcer Functional Limitation Score Questionnaire

Stienstra, Ymkje; Dijkstra, Pieter U.; Wezel, Marieke J van; Roest, Margijske H. G. van; Beets, Michiel; Zijlstra, Ijsbrand A.J.; Johnson, Roch Christian; Ampadu, Edwin; Gbovi, Jules; Zinsou, Claude; Etuaful, Samuel; Klutse, Erasmus; Graaf, Winette T.A. van der; Werf, Tjip S van der

doi:10.4269/ajtmh.2005.72.449

Cited by 23 publications

(30 citation statements)

References 15 publications

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“…Data on functional limitation was collected using the Buruli Ulcer Functional Limitation Score Questionnaire (BUFLSQ). Functional limitation was defined as impairment in carrying out daily activities as a result of BU [22,23]. Daily activities listed in the BUFLSQ irrelevant to a BU patient (either because the patient is too young or old to perform the task), was recorded as not applicable.…”

Section: Methodsmentioning

confidence: 99%

Household cost of out-patient treatment of Buruli ulcer in Ghana: a case study of Obom in Ga South Municipality

Amoakoh

Aikins

2013

BMC Health Serv Res

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BackgroundThe economic burden of diseases has become increasingly relevant to policy makers as healthcare expenditure keep rising in the face of limited and competing resources. Buruli ulcer (BU), a neglected but treatable tropical disease caused by Mycobacterium ulcerans, the only known environmental mycobacterium is capable of causing long term disability when left untreated. However, most BU studies have tended to focused on its bacteriology, epidemiology, entomology and other social determinants to the neglect of its economic evaluation. This paper reports estimated the household economic costs of BU and describe the intangible cost suffered by BU patients in an endemic area.MethodsRetrospective one year cost data was used. A total of 63 confirmed BU cases were randomly sampled for the study. Economic cost and cost burden of BU were estimated. Sensitivity analysis was conducted to test the robustness of the cost estimates. Intangible cost measured stigmatization, pain, functional limitation and social isolation of children.ResultsThe annual total household economic cost was US$35,915.98, of which about 65% was cost incurred by children with a mean cost of US$521.04. The mean annual household cost was US$570.09. The direct cost was 96% of the total cost. Non-medical cost accounts for about 97% of the direct cost with a mean cost of US$529.27. The mean medical cost was US$18.94. The main cost drivers of the household costs were transportation (78%) and food (12%). Caregivers and adult patients lost a total of 535 productive days seeking care, which gives an indirect cost valued at US$1,378.67 with a mean of US$21.88. A total of 365 school days (about 1 year) were lost by 19 BU patients (mean, 19.2 days). Functional loss and pain were low, and stigma rated moderate. Most children suffering from BU (84%) were socially isolated.ConclusionHousehold cost burden of out-patient BU ulcer treatment was high. Household cost of BU is therefore essential in the design of its intervention. BU afflicted children experience social isolation.

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Section: Methodsmentioning

confidence: 99%

Household cost of out-patient treatment of Buruli ulcer in Ghana: a case study of Obom in Ga South Municipality

Amoakoh

Aikins

2013

BMC Health Serv Res

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“…The avoidance of aggressive surgical procedures produces more satisfactory functional results. 58 It has been observed that extensive and unnecessary surgeries can damage healthy tissues and do not prevent relapses. For patients with facial lesions, surgery is not a treatment option.…”

Section: Treatmentmentioning

confidence: 99%

“…Patients not treated early often suffer from functional disabilities in the long run, with joint movement impairment, which restricts their ability to execute and participate in daily activities. 5,6 Early diagnosis and a specific treatment for BU associated with interventions that prevent disabilities are crucial for satisfactory treatment results. 7,8 When necessary, surgery associated with antimicrobial therapy is the recommended treatment.…”

Section: Introductionmentioning

confidence: 99%

Úlcera de Buruli

Boleira

Lupi

Lehman³

et al. 2010

An. Bras. Dermatol.

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Buruli ulcer, an infectious disease caused by Mycobacterium ulcerans, is the third most prevalent mycobacteriosis, after tuberculosis and leprosy. This atypical mycobacteriosis has been reported in over 30 countries, mainly those with tropical and subtropical climates, but its epidemiology remains unclear. The first autochthonous cases of infection in Brazil have recently been described, making this diagnosis important for Brazilian dermatologists. Clinical manifestations vary from nodules, areas of edema, and plaques, but the most typical presentation is a large ulcer, usually in the limbs. Despite considerable knowledge about its clinical manifestations in some endemic countries, in other areas the diagnosis may be overlooked. Therefore, physicians should be educated about Buruli ulcer, since early diagnosis and treatment, including measures to prevent disability, are essential for a good outcome. Keywords: Buruli ulcer; Mycobacterium infections, atypical; Mycobacterium ulcerans; World Health Organization Resumo: A úlcera de Buruli, uma doença infecciosa causada pela Mycobacterium ulcerans (M. ulcerans), é a terceira micobacteriose em ocorrência, após a hanseníase e a tuberculose. Essa micobacteriose atípica tem sido relatada em mais de 30 países, principalmente, nos que têm climas tropicais e subtropicais, mas a sua epidemiologia permanece obscura. Recentemente, os primeiros casos autóc-tones do Brasil foram relatados, fazendo com que dermatologistas brasileiros estejam atentos a esse diagnóstico. O quadro clínico varia: nódulos, áreas de edema, placas, mas a manifestação mais típica é uma grande úlcera, que ocorre, em geral, nas pernas ou nos braços. Apesar do amplo conhecimento quanto ao seu quadro clínico em países endêmicos, nas outras áreas, esse diagnóstico pode passar despercebido. Assim, médicos devem ser orientados quanto à úlcera de Buruli, pois o diagnóstico precoce, o tratamento específico e a introdução de cuidados na prevenção de incapacidades são essenciais para uma boa evolução. Palavras-chave: Infecções atípicas por mycobacterium; Mycobacterium ulcerans; Organização Mundial de Saúde; Úlcera de Buruli

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“…Using this system, 362 (57%) of 638 patients in Benin and Ghana had persistent functional limitation after 4 years. 112 The average limitation score was variable with 31% in Benin and 15% in Ghana. The mean limitation score in 65 patients without visible contractures was 13%, whereas in 23 patients with visible contractures or an amputation it was >50%.…”

Section: Functional Limitationsmentioning

confidence: 99%

“…110 A BU functional limitation scoring system has been developed to assess the nature and severity of limitation, 111 which is helpful in clinical trials of treatment. 112 The BU functional limitation scoring system comprises a list of daily activities that were investigated in patients with BU in Benin and Ghana following treatment. Using this system, 362 (57%) of 638 patients in Benin and Ghana had persistent functional limitation after 4 years.…”

Section: Functional Limitationsmentioning

confidence: 99%

Buruli ulcer: wound care and rehabilitation

Frimpong¹,

Duah²,

Wansbrough‐Jones³

et al. 2016

CWCMR

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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients' rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.

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Reliability and Validity of the Buruli Ulcer Functional Limitation Score Questionnaire

Cited by 23 publications

References 15 publications

Household cost of out-patient treatment of Buruli ulcer in Ghana: a case study of Obom in Ga South Municipality

Household cost of out-patient treatment of Buruli ulcer in Ghana: a case study of Obom in Ga South Municipality

Úlcera de Buruli

Buruli ulcer: wound care and rehabilitation

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