Buruli Ulcer Patients Cannot Afford Free Treatment

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Main Category: Tropical Diseases
Also Included In: Infectious Diseases / Bacteria / Viruses;  Public Health
Article Date: 15 Oct 2008 - 0:00 PDT

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In Central Cameroon, despite care given free-of-charge for Buruli ulcer (BU,) patients' economic and social costs are preventing or delaying possible treatment, according to an article published on October 15, 2008 in the open-access journal PLoS Neglected Tropical Diseases.

The Buruli ulcer is a tropical disease caused by Mycobacterium ulcerans, a relative of the bacteria that cause tuberculosis and leprosy. It is characterized by skin lesions which persist without healing. In the most serious cases, BU can require amputation of the affected limbs or serious deformity.

Buruli ulcer was named for an area of Uganda where it was once highly prevalent, and according to the World Health Organization, it is present in over 30 countries, with the most heavily affected countries in Western Africa.  Despite available free treatment, it is common for patients to abandon treatment or even for their families to abandon them in treatment.

To investigate this problem, PASS International performed an ethnographic study in the endemic regions of Ayos and Akonolinga. This study included qualitative observation through patient shadowing, in depth interviews, and focus group discussion. Further, quantitative data was taken through questionnaires.

The group discovered that, between the added costs of transportation to the hospital, earnings lost while caring for the patients and other hidden living expenses often put families in a position of needing to leave the lives of the hospitalized family members. At the time of the study, more than half of all patients (62%) had been abandoned at the hospital due to the extra costs, which ultimately accounted for up to one-quarter of the household's yearly earnings.

As a result, many Buruli ulcer victims cease treatment before it is complete or avoid it all together. This abandonment has serious repercussions because there are devastating future consequences including deformity, disability, and loss of livelihood, which further result in impoverishment, according to the authors.

In conclusion, the study recommends that future methods attempt to bring treatment to the victim, thus reducing the social and economic burden of BU. Presently, Leprosy Relief Emmaus-Switzerland, in collaboration with Cameroon's Ministry of Health, taken steps to decentralize treatment, including early detection and antibiotic treatments on a local level. This intervention must be further evaluated for fuller insight on improving patients' access to treatment in low-income settings.

"It Is Me Who Endures but My Family That Suffers'': Social Isolation as a Consequence of the Household Cost Burden of Buruli Ulcer Free of Charge Hospital Treatment.
Peeters Grietens K, Um Boock A, Peeters H, Hausmann-Muela S, Toomer E, et al. (2008) ''
PLoS Negl Trop Dis 2(10): e321.
doi:10.1371/journal.pntd.0000321
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Written by Anna Sophia McKenney
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