Community Knowledge, Perceptions and Attitudes Regarding Buruli Ulcer in Bafia Health District, Centre Region-Cameroon
Abstract
Background
Buruli ulcer (BU), a neglected tropical disease, occurs in about thirty-three countries tropical countries world-wide. Misconceptions about BU leads to poor health-seeking behaviors. This study explored community knowledge, perceptions and attitudes regarding BU.
Methods
We conducted a cross-sectional household survey in selected communities of Bafia Health District, Centre region of Cameroon.
Results
We had 1,341 respondents aged 10–87 years and a mean age of 34.8±18.4yrs. About 53% were males, 50.1% were married, and majority were Christians. Some 30.1% had heard about and 21.1% knew someone with BU. Major sources of information on BU were: family members(29%), friends(21%) and school(14%). Only 17.2% of respondents correctly identified a manifestation of BU, and 2.3% knew BU its cause. A considerable proportion attributed BU to witchcraft(8%), poor hygiene(9.8%) and spontaneous occurrence(5.3%). Only 19.2% believed BU was curable, of whom 78.6% advised on health facilities, meanwhile 8.2% preferred traditional healers for treatment. Attitudes towards persons with BU (PWBU) were mostly negative as only 27.4% would show them respect, 19,5% would shake hands, and 16.4% would share the same plate with them. Additionally, only 17.3% approved their participation, and 14.1% and 12.2% respectively would allow their child to play with or marry a PWBU. Factors associated with positive attitudes included: having head about BU, knowing a PWBU, understanding that BU is curable and treatable in hospital, having attained at least secondary education. Negative attitudes were associated with beliefs that BU is caused by supernatural forces, poor hygiene, or living with a PWBU.
Conclusion
There was poor community knowledge and perceptions about BU in the BHD, which negatively influenced community attitudes towards PWBU. A community education intervention focusing on the natural occurrence, biological etiology, non-hereditary nature, the non-human-to-human transmission, and the curable nature of BU could improve upon the situation in BHD.
Author summary
Buruli Ulcer (BU), a neglected tropical disease, leads to soft-tissue destruction and physical deformities if not detected early and treated adequately. Poor community understanding and misconceptions leads to poor health-seeking behaviours among victims. We explored community knowledge, perceptions and attitudes among 1341 participants in Bafia health district, centre region, Cameroon. Our respondents were not familiar and had poor knowledge as well as erroneous perceptions regarding BU. as less than 1/3rd had heard, and less than a quarter knew someone with BU. Less than 1/5th knew the manifestation of BU, and as low as 2.3% knew the its cause, with many attributing BU to witchcraft, poor hygiene and spontaneous occurrence. Very few believed that BU is curable and treatable in health facilities. Attitudes towards PWBU were negative, as very few would shake hands, share the same plate, or allow their participation in community life. Drivers of negative attitudes were the beliefs that BU is caused by supernatural forces, poor hygiene, or living with a PWBU. A community education programmes on BU, focusing on its natural occurrence, the non-human-to-human transmission, and its curable nature, could improve upon community knowledge and attitudes regarding BU in Bafia health district.
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