Velink Anita, Woolley Rebecca J, Phillips Richard O, Abass Kabiru M, van der Werf Tjip S, Agumah Emmanuel, de Zeeuw Janine, Klis Sandor, Stienstra Ymkje
University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Kwame Nkrumah University of Science and Technology, School of Medical Sciences, Department of Medicine, Kumasi, Ghana.
PLoS Negl Trop Dis. 2016 Dec 29;10(12):e0005261. doi: 10.1371/journal.pntd.0005261. eCollection 2016 Dec.
Buruli ulcer (BU), caused by Mycobacterium ulcerans, is a neglected tropical disease frequently leading to permanent disabilities. The ulcers are treated with rifampicin and streptomycin, wound care and, if necessary surgical intervention. Professionals have exclusively shaped the research agenda concerning management and control, while patients' perspective on priorities and preferences have not explicitly been explored or addressed.
METHODOLOGY/PRINCIPAL FINDINGS: To get insight into patient perception of the management and control of Buruli ulcer a mixed methods research design was applied with a questionnaire and focus group discussions among former BU patients. Data collection was obtained in collaboration with a local team of native speakers in Ghana. A questionnaire was completed by 60 former patients and four focus group discussions were conducted with eight participants per group. Former patients positively evaluated both the effectiveness of the treatment and the financial contribution received for the travel costs to the hospitals. Pain experienced during treatment procedures, in particular wound care and the streptomycin injections, and the side-effects of the treatment were negatively evaluated. Former patients considered the development of preventive measures and knowledge on the transmission as priorities. Additionally, former patients asked for improved accessibility of health services, counselling and economic support.
These findings can be used to improve clinical management and to guide the international research agenda.
由溃疡分枝杆菌引起的布鲁里溃疡是一种被忽视的热带病,常导致永久性残疾。溃疡的治疗方法包括使用利福平和链霉素、伤口护理,必要时进行手术干预。专业人员完全主导了有关管理和控制的研究议程,而患者对优先事项和偏好的看法尚未得到明确探讨或关注。
方法/主要发现:为了深入了解患者对布鲁里溃疡管理和控制的看法,采用了混合方法研究设计,对布鲁里溃疡康复患者进行问卷调查和焦点小组讨论。数据收集是与加纳当地的母语团队合作进行的。60名康复患者完成了问卷调查,进行了4次焦点小组讨论,每组8名参与者。康复患者对治疗效果和获得的前往医院的差旅费补贴给予了积极评价。对治疗过程中经历的疼痛,特别是伤口护理和链霉素注射时的疼痛,以及治疗的副作用给予了负面评价。康复患者认为制定预防措施和了解传播知识是优先事项。此外,康复患者要求改善医疗服务的可及性、咨询服务和经济支持。
这些发现可用于改善临床管理并指导国际研究议程。