Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana
Identifieur interne : 000722 ( Main/Exploration ); précédent : 000721; suivant : 000723Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana
Auteurs : Mercy M. Ackumey [Ghana, Suisse] ; Margaret Gyapong [Ghana] ; Matilda Pappoe [Ghana] ; Cynthia Kwakye-Maclean [Ghana] ; Mitchell G. Weiss [Suisse]Source :
- BMC Public Health [ 1471-2458 ] ; 2012.
Abstract
Ghana is a Buruli ulcer (BU) endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra.
Semi-structured interviews based on the Explanatory Model Interview Catalogue framework were administered to 181 respondents comprising 15 respondents with pre-ulcers and 166 respondents with ulcers. The Wilcoxon rank-sum test was used to compare categories of illness experiences (PD) and perceived causes (PC) among respondents with pre-ulcer and ulcer conditions. The Fisher’s exact test was used to compare the most troubling PD and the most important PC variables. Qualitative phenomenological analysis of respondents’ narratives clarified illness experiences and meanings with reference to PC and PD variables.
Families of respondents with pre-ulcers and the respondents themselves were often anxious about disease progression, while families of respondents with ulcers, who had to give care, worried about income loss and disruption of school attendance. Respondents with pre-ulcers frequently reported swimming in ponds and rivers as a perceived cause and considered it as the most important PC (53.3%). Respondents with ulcers frequently attributed their BU illness to witchcraft (64.5%) and respondents who claimed they had no water contact, questioned the credibility of health messages
Affected persons with pre-ulcers are likely to delay treatment because of social and financial constraints and the absence of pain. Scepticism on the role of water in disease contagion and prolonged healing is perceived to make ideas of witchcraft as a PC more credible, among respondents with ulcers. Health messages should address issues of locally perceived risk and vulnerability. Guided by study findings, further research on the role of environmental, socio-cultural and genetic factors in BU contagion, is also needed to clarify and formulate health messages and strengthen public health initiatives.
Url:
DOI: 10.1186/1471-2458-12-264
PubMed: 22471884
PubMed Central: 3350433
Affiliations:
Links toward previous steps (curation, corpus...)
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Le document en format XML
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Ackumey</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, College of Health Sciences, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Gyapong, Margaret" sort="Gyapong, Margaret" uniqKey="Gyapong M" first="Margaret" last="Gyapong">Margaret Gyapong</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, College of Health Sciences, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Dodowa Health Research Centre, Ghana Health Service, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Dodowa Health Research Centre, Ghana Health Service</wicri:regionArea><wicri:noRegion>Ghana Health Service</wicri:noRegion></affiliation></author><author><name sortKey="Pappoe, Matilda" sort="Pappoe, Matilda" uniqKey="Pappoe M" first="Matilda" last="Pappoe">Matilda Pappoe</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, College of Health Sciences, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Kwakye Maclean, Cynthia" sort="Kwakye Maclean, Cynthia" uniqKey="Kwakye Maclean C" first="Cynthia" last="Kwakye-Maclean">Cynthia Kwakye-Maclean</name><affiliation wicri:level="1"><nlm:aff id="I5">Ga-West Municipal Health Administration, Amasaman, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Ga-West Municipal Health Administration, Amasaman</wicri:regionArea><wicri:noRegion>Amasaman</wicri:noRegion></affiliation></author><author><name sortKey="Weiss, Mitchell G" sort="Weiss, Mitchell G" uniqKey="Weiss M" first="Mitchell G" last="Weiss">Mitchell G. Weiss</name><affiliation wicri:level="1"><nlm:aff id="I2">Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22471884</idno><idno type="pmc">3350433</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350433</idno><idno type="RBID">PMC:3350433</idno><idno type="doi">10.1186/1471-2458-12-264</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">000399</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000399</idno><idno type="wicri:Area/Pmc/Curation">000398</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000398</idno><idno type="wicri:Area/Pmc/Checkpoint">000348</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000348</idno><idno type="wicri:Area/Ncbi/Merge">000480</idno><idno type="wicri:Area/Ncbi/Curation">000480</idno><idno type="wicri:Area/Ncbi/Checkpoint">000480</idno><idno type="wicri:Area/Main/Merge">000723</idno><idno type="wicri:Area/Main/Curation">000722</idno><idno type="wicri:Area/Main/Exploration">000722</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana</title><author><name sortKey="Ackumey, Mercy M" sort="Ackumey, Mercy M" uniqKey="Ackumey M" first="Mercy M" last="Ackumey">Mercy M. Ackumey</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, College of Health Sciences, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author><author><name sortKey="Gyapong, Margaret" sort="Gyapong, Margaret" uniqKey="Gyapong M" first="Margaret" last="Gyapong">Margaret Gyapong</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, College of Health Sciences, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Dodowa Health Research Centre, Ghana Health Service, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Dodowa Health Research Centre, Ghana Health Service</wicri:regionArea><wicri:noRegion>Ghana Health Service</wicri:noRegion></affiliation></author><author><name sortKey="Pappoe, Matilda" sort="Pappoe, Matilda" uniqKey="Pappoe M" first="Matilda" last="Pappoe">Matilda Pappoe</name><affiliation wicri:level="4"><nlm:aff id="I1">School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>School of Public Health, College of Health Sciences, University of Ghana, Legon</wicri:regionArea><orgName type="university">Université du Ghana</orgName><placeName><settlement type="city">Accra</settlement><settlement type="town">Legon (Ghana)</settlement><region type="region">Région du Grand Accra</region></placeName></affiliation></author><author><name sortKey="Kwakye Maclean, Cynthia" sort="Kwakye Maclean, Cynthia" uniqKey="Kwakye Maclean C" first="Cynthia" last="Kwakye-Maclean">Cynthia Kwakye-Maclean</name><affiliation wicri:level="1"><nlm:aff id="I5">Ga-West Municipal Health Administration, Amasaman, Ghana</nlm:aff><country xml:lang="fr">Ghana</country><wicri:regionArea>Ga-West Municipal Health Administration, Amasaman</wicri:regionArea><wicri:noRegion>Amasaman</wicri:noRegion></affiliation></author><author><name sortKey="Weiss, Mitchell G" sort="Weiss, Mitchell G" uniqKey="Weiss M" first="Mitchell G" last="Weiss">Mitchell G. Weiss</name><affiliation wicri:level="1"><nlm:aff id="I2">Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Swiss Tropical and Public Health Institute, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I3">University of Basel, Basel, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>University of Basel, Basel</wicri:regionArea><wicri:noRegion>Basel</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Public Health</title><idno type="eISSN">1471-2458</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Ghana is a Buruli ulcer (BU) endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra.</p></sec><sec><title>Methods</title><p>Semi-structured interviews based on the Explanatory Model Interview Catalogue framework were administered to 181 respondents comprising 15 respondents with pre-ulcers and 166 respondents with ulcers. The Wilcoxon rank-sum test was used to compare categories of illness experiences (PD) and perceived causes (PC) among respondents with pre-ulcer and ulcer conditions. The Fisher’s exact test was used to compare the most troubling PD and the most important PC variables. Qualitative phenomenological analysis of respondents’ narratives clarified illness experiences and meanings with reference to PC and PD variables.</p></sec><sec><title>Results</title><p>Families of respondents with pre-ulcers and the respondents themselves were often anxious about disease progression, while families of respondents with ulcers, who had to give care, worried about income loss and disruption of school attendance. Respondents with pre-ulcers frequently reported swimming in ponds and rivers as a perceived cause and considered it as the most important PC (53.3%). Respondents with ulcers frequently attributed their BU illness to witchcraft (64.5%) and respondents who claimed they had no water contact, questioned the credibility of health messages</p></sec><sec><title>Conclusions</title><p>Affected persons with pre-ulcers are likely to delay treatment because of social and financial constraints and the absence of pain. Scepticism on the role of water in disease contagion and prolonged healing is perceived to make ideas of witchcraft as a PC more credible, among respondents with ulcers. Health messages should address issues of locally perceived risk and vulnerability. Guided by study findings, further research on the role of environmental, socio-cultural and genetic factors in BU contagion, is also needed to clarify and formulate health messages and strengthen public health initiatives.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Johnson, Pd" uniqKey="Johnson P">PD Johnson</name></author><author><name sortKey="Stinear, T" uniqKey="Stinear T">T Stinear</name></author><author><name sortKey="Small, Pl" uniqKey="Small P">PL Small</name></author><author><name sortKey="Pluschke, G" uniqKey="Pluschke G">G Pluschke</name></author><author><name sortKey="Merritt, Rw" uniqKey="Merritt R">RW Merritt</name></author><author><name sortKey="Portaels, F" uniqKey="Portaels F">F Portaels</name></author><author><name sortKey="Huygen, K" uniqKey="Huygen K">K Huygen</name></author><author><name sortKey="Hayman, Ja" uniqKey="Hayman J">JA Hayman</name></author><author><name sortKey="Asiedu, K" 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McCowan</name></author><author><name sortKey="Johnson, Pd" uniqKey="Johnson P">PD Johnson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Portaels, F" uniqKey="Portaels F">F Portaels</name></author><author><name sortKey="Elsen, P" uniqKey="Elsen P">P Elsen</name></author><author><name sortKey="Guimaraes Peres, A" uniqKey="Guimaraes Peres A">A Guimaraes-Peres</name></author><author><name sortKey="Fonteyne, Pa" uniqKey="Fonteyne P">PA Fonteyne</name></author><author><name sortKey="Meyers, Wm" uniqKey="Meyers W">WM Meyers</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Ghana</li><li>Suisse</li></country><region><li>Région du Grand Accra</li></region><settlement><li>Accra</li><li>Legon (Ghana)</li></settlement><orgName><li>Université du Ghana</li></orgName></list><tree><country name="Ghana"><region name="Région du Grand Accra"><name sortKey="Ackumey, Mercy M" sort="Ackumey, Mercy M" uniqKey="Ackumey M" first="Mercy M" last="Ackumey">Mercy M. Ackumey</name></region><name sortKey="Gyapong, Margaret" sort="Gyapong, Margaret" uniqKey="Gyapong M" first="Margaret" last="Gyapong">Margaret Gyapong</name><name sortKey="Gyapong, Margaret" sort="Gyapong, Margaret" uniqKey="Gyapong M" first="Margaret" last="Gyapong">Margaret Gyapong</name><name sortKey="Kwakye Maclean, Cynthia" sort="Kwakye Maclean, Cynthia" uniqKey="Kwakye Maclean C" first="Cynthia" last="Kwakye-Maclean">Cynthia Kwakye-Maclean</name><name sortKey="Pappoe, Matilda" sort="Pappoe, Matilda" uniqKey="Pappoe M" first="Matilda" last="Pappoe">Matilda Pappoe</name></country><country name="Suisse"><noRegion><name sortKey="Ackumey, Mercy M" sort="Ackumey, Mercy M" uniqKey="Ackumey M" first="Mercy M" last="Ackumey">Mercy M. Ackumey</name></noRegion><name sortKey="Ackumey, Mercy M" sort="Ackumey, Mercy M" uniqKey="Ackumey M" first="Mercy M" last="Ackumey">Mercy M. Ackumey</name><name sortKey="Weiss, Mitchell G" sort="Weiss, Mitchell G" uniqKey="Weiss M" first="Mitchell G" last="Weiss">Mitchell G. Weiss</name><name sortKey="Weiss, Mitchell G" sort="Weiss, Mitchell G" uniqKey="Weiss M" first="Mitchell G" last="Weiss">Mitchell G. Weiss</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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