Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana.
Background Buruli ulcer is a chronic ulcerating skin condition, with the highest burden found in Central and West Africa where it disproportionately affects the most vulnerable populations. Treatment is demanding, comprising eight-weeks of daily antibiotics, regular wound care and possible surgical...
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ftdoajarticles:oai:doaj.org/article:b92e675f9fc14f05bebbe4a4515ecb56 2023-05-15T15:14:06+02:00 Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana. Shelui Collinson Venus N B Frimpong Bernadette Agbavor Bethany Montgomery Michael Oppong Michael Frimpong Yaw A Amoako Michael Marks Richard O Phillips 2020-05-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0008369 https://doaj.org/article/b92e675f9fc14f05bebbe4a4515ecb56 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0008369 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008369 https://doaj.org/article/b92e675f9fc14f05bebbe4a4515ecb56 PLoS Neglected Tropical Diseases, Vol 14, Iss 5, p e0008369 (2020) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1371/journal.pntd.0008369 2022-12-31T11:50:15Z Background Buruli ulcer is a chronic ulcerating skin condition, with the highest burden found in Central and West Africa where it disproportionately affects the most vulnerable populations. Treatment is demanding, comprising eight-weeks of daily antibiotics, regular wound care and possible surgical intervention. Treatment completion is key to optimising outcomes, however the degree of and barriers to this are not well understood. Recent change from injectable treatment (SR8) to oral treatment (CR8) has made it feasible to further decentralise care, potentially improving treatment access and completion. However, the impact of this and of other demographic and clinical influences on treatment completion must be explored first to ensure appropriate models of care are developed. Methodology/principal findings A retrospective clinical notes review and secondary data analysis of records from patients diagnosed between 1 January 2006-31 December 2018 at four district hospital clinics in the Ashanti and Central Regions, Ghana. Univariable analyses and multivariable logistic regression were performed to assess the association between explanatory variables and treatment completion. There were 931 patient episodes across the four clinics with overall treatment completion of 84.4%. CR8 was associated with higher treatment completion compared to SR8 (OR 4.1, P = 0.001). There was no statistically significant association found between distance from patient residence to clinic and treatment completion. Conclusions/significance Improved treatment completion with CR8 supports its use as first line therapy and may enable decentralisation to fully community-based care. We did not find an association between distance to care and treatment completion, though analyses were limited by data availability. However, we did find evidence that distance to care continues to be associated with more severe forms of disease, which may reflect the higher costs of accessing care and lower awareness of the condition the further a patient lives. ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 14 5 e0008369 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Shelui Collinson Venus N B Frimpong Bernadette Agbavor Bethany Montgomery Michael Oppong Michael Frimpong Yaw A Amoako Michael Marks Richard O Phillips Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Buruli ulcer is a chronic ulcerating skin condition, with the highest burden found in Central and West Africa where it disproportionately affects the most vulnerable populations. Treatment is demanding, comprising eight-weeks of daily antibiotics, regular wound care and possible surgical intervention. Treatment completion is key to optimising outcomes, however the degree of and barriers to this are not well understood. Recent change from injectable treatment (SR8) to oral treatment (CR8) has made it feasible to further decentralise care, potentially improving treatment access and completion. However, the impact of this and of other demographic and clinical influences on treatment completion must be explored first to ensure appropriate models of care are developed. Methodology/principal findings A retrospective clinical notes review and secondary data analysis of records from patients diagnosed between 1 January 2006-31 December 2018 at four district hospital clinics in the Ashanti and Central Regions, Ghana. Univariable analyses and multivariable logistic regression were performed to assess the association between explanatory variables and treatment completion. There were 931 patient episodes across the four clinics with overall treatment completion of 84.4%. CR8 was associated with higher treatment completion compared to SR8 (OR 4.1, P = 0.001). There was no statistically significant association found between distance from patient residence to clinic and treatment completion. Conclusions/significance Improved treatment completion with CR8 supports its use as first line therapy and may enable decentralisation to fully community-based care. We did not find an association between distance to care and treatment completion, though analyses were limited by data availability. However, we did find evidence that distance to care continues to be associated with more severe forms of disease, which may reflect the higher costs of accessing care and lower awareness of the condition the further a patient lives. ... |
format |
Article in Journal/Newspaper |
author |
Shelui Collinson Venus N B Frimpong Bernadette Agbavor Bethany Montgomery Michael Oppong Michael Frimpong Yaw A Amoako Michael Marks Richard O Phillips |
author_facet |
Shelui Collinson Venus N B Frimpong Bernadette Agbavor Bethany Montgomery Michael Oppong Michael Frimpong Yaw A Amoako Michael Marks Richard O Phillips |
author_sort |
Shelui Collinson |
title |
Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana. |
title_short |
Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana. |
title_full |
Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana. |
title_fullStr |
Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana. |
title_full_unstemmed |
Barriers to Buruli ulcer treatment completion in the Ashanti and Central Regions, Ghana. |
title_sort |
barriers to buruli ulcer treatment completion in the ashanti and central regions, ghana. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pntd.0008369 https://doaj.org/article/b92e675f9fc14f05bebbe4a4515ecb56 |
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Arctic |
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Arctic |
genre |
Arctic |
genre_facet |
Arctic |
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PLoS Neglected Tropical Diseases, Vol 14, Iss 5, p e0008369 (2020) |
op_relation |
https://doi.org/10.1371/journal.pntd.0008369 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008369 https://doaj.org/article/b92e675f9fc14f05bebbe4a4515ecb56 |
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https://doi.org/10.1371/journal.pntd.0008369 |
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PLOS Neglected Tropical Diseases |
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