Utilising community volunteers can increase the detection and referral of Buruli ulcer cases in endemic communities in Southeast, Nigeria

• Published in: Tropical Diseases, Travel Medicine and Vaccines
• Main Authors: Chihurumnanya Alo, Ijeoma Nkem Okedo-Alex, Ifeyinwa Chizoba Akamike, Adaoha Pearl Agu, Ifeyinwa Maureen Okeke, Chidinma Ihuoma Amuzie, Nneamaka C. Alo
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2022
• Subjects: Buruli ulcer; Community volunteers; Case detection; Hospital referral; Neglected tropical disease; Nigeria; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1186/s40794-022-00181-7; https://doaj.org/article/3e75c66b26214eef91d132e22cf7087a

Abstract Background Buruli ulcer (BU) is a debilitating neglected tropical disease which causes disability and mostly affects inhabitants in impoverished settings where access to medical care is challenging. This study aims to determine the effect of training community members as volunteers for or in the detection and referral of people who have Buruli ulcer to the hospital. Methods The following study is a before and after study in the BU-endemic Local Government Areas (LGA) of Ebonyi State. A cluster random sampling technique was used to select 90 volunteers from three LGAs (30 from each LGA). In each LGA, the volunteers underwent a one-day training and six months field work to identify all those who have any form of ulcer on any part of their bodies. A short questionnaire was used to capture socio-demographic characteristics of the patient, site of the ulcer, duration of the ulcer, initial appearance of the ulcer, referral to hospital, result of laboratory investigation, and treatment received. The data was analysed using the Statistical Package for Social Sciences (SPSS) for Microsoft Windows version 20 software. The Z test statistic was used to compare the number of referred BU patients before and after the intervention by LGA. The Chi square test was used to examine the association between the dependent and independent variables. Results The mean age of volunteers was 39 ± 9.5 while mean age of the patients was 42.3 ± 17.1. Most of the ulcers were on the legs (79.4%) and lasted 1–5 years (65.6%). There was a significant increase in the proportion of BU suspects identified by the community volunteers in all 3 LGAs (Afikpo north (p = < 0.001), Abakaliki (p = 0.02), Ikwo (p = 0.001). The duration of the ulcer was associated with the detection and referral of the patients with higher levels of detection and referral among those whose ulcer had lasted 1–5 years in two of the LGAs (P < 0.001). Conclusion We recommend that program managers and stakeholders integrate and scale up the services of trained ...