Abstract
Background: Mycobacterium ulcerans disease referred to as Buruli ulcer (BU) is a health burden in West African sub-region. The mysterious nature of BU is ascribed to peculiarities surrounding
its mode of transmission and pathology. Buruli ulcer is predominantly found in rural communities with difficulty in assessing the true prevalence because of poor understanding of the disease as well as disinclination towards quality health-seeking behaviors which leads to underreporting of the disease. This study was designed to ascertain the extent of knowledge of BU, the attitudinal disposition of inhabitants in the susceptible communities and predisposing practices which might increase their risk to the disease.
Methods: A descriptive cross-sectional Knowledge, Attitude and Practices (KAP) survey was conducted in eight randomly selected Local Government Areas in Ogun State from May 2014 to
July 2015. Purposive (respondents with cases of BU) and simple random sampling were employed for this study. Structured pre-tested questionnaire was administered to consenting
respondents from selected communities. Data generated were analyzed using Pearson’s Chisquare and logistic regression.
Results: Respondents showed (69.7%, 7.2%, 46.7%) good knowledge, attitude and practices towards BU, respectively. Majority (62%) believed BU to be an affliction of spiritual or ancestral
origin. There was significant association between BU knowledge and occupation (÷2 = 9.952, df =4, p-value=0.041); attitude and education (÷2 = 20.058, df=3, p-value=0.000) and predisposing practices with age, education and occupation ( ÷2 = 13.788, df=3, p-value=0.003, ÷2 = 8.295, df=3, p-value=0.04, ÷2 = 40.544, df=4, p-value=0.000), respectively.
Conclusion: Despite the relatively good knowledge, there was generalized reluctance of associating with BU patients shown by the marked poor attitude recorded in this study. It is obvious that the populations under study were ignorant, hence susceptible to increased exposure to the risks of BU. Buruli ulcer enlightenment programs should be initiated in the affected communities in Ogun State.
Keywords: Buruli ulcer, mycobacterium ulcerans KAP survey, rural populace.
Résumé
Contexte : La maladie Mycobacterium ulcerans dénommée ulcère de Buruli (UB) est un fardeau pour la santé dans la sous-région de l’Afrique de l’Ouest. La nature mystérieuse de l’UB est
attribuée aux particularités de son mode de transmission et de sa pathologie. L’ulcère de Buruli se rencontre principalement dans les communautés rurales avec des difficultés à évaluer la prévalence réelle en raison d’une mauvaise compréhension de la maladie et d’un manque de volonté d’adopter des comportements de qualité qui favorisent la santé ce qui conduit à une sous-déclaration de la maladie. Cette étude visait à déterminer l’étendue des connaissances sur l’UB, la disposition attitudinale des habitants des communautés vulnérables et les pratiques prédisposant susceptibles d’accroître leur risque de contracter la maladie.
Méthodes : Une enquête descriptive transversale sur les connaissances, les attitudes et les pratiques (CAP) a été menée dans huit communes sélectionnées de manière aléatoire dans l’État d’Ogun, de mai 2014 à juillet 2015. Un échantillonnage au choix (les répondants avec cas d’UB) et un échantillonnage aléatoire simple ont été utilisés pour cette étude. Un questionnaire pré testé structuré a été administré aux répondants consentants des communautés sélectionnées. Les données générées ont été analysées à l’aide de la régression logistique et du chi carré de Pearson.
Résultats : Les répondants ont montré (69,7%, 7,2%, 46,7%) de bonnes connaissances, attitudes et pratiques vis-à-vis de l’UB, respectivement. La majorité (62%) pensait que l’UB était une affliction d’origine spirituelle ou ancestrale. Il existait une association significative entre la connaissance de l’UB et la profession (χ2= 9,952, df = 4, valeur p = 0,041); attitude et éducation (χ2 = 20.058, df = 3, p-value = 0,000) et pratiques prédisposant avec l’âge, l’éducation et la profession (χ2 = 13,788 df = 3, p-value = 0,003 ; χ2 = 8,295, df = 3, valeur p = 0,04 ; χ2 = 40,544, df = 4, p-value = 0,000), respectivement.
Conclusion : En dépit de connaissances relativement bonnes, il existait une réticence généralisée à s’associer aux patients atteints d’UB révélée par l’attitude nettement médiocre enregistrée dans
cette étude. Il est évident que la population étudiée était ignorante et donc susceptible d’être davantage exposée aux risques de l’UB. Des programmes de sensibilisation à l’ulcère de Buruli devraient être lancés dans les communautés touchées de l’Étatd’Ogun.
Mots clés : Mycobacterium ulcerans, au hasard, questionnaire, prédisposant, ulcère de Buruli
Correspondence: Dr. Patricia I. Otuh, Veterinary Teaching Hospital, University of Ibadan, Ibadan, Nigeria. E-mail: ifunanyachukwu.ihuaku@gmail.com
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