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    Developing a Buruli ulcer community of practice in Bankim, Cameroon: A model for Buruli ulcer outreach in Africa

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    journal.pntd.0006238.pdf
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    Author
    Awah, Paschal Kum
    Boock, Alphonse Um
    Mou, Ferdinand
    Koin, Joseph Tohnain
    Anye, Evaristus Mbah
    Noumen, Djeunga
    Nichter, Mark
    Affiliation
    Univ Arizona, Sch Anthropol
    Issue Date
    2018-03
    
    Metadata
    Show full item record
    Publisher
    PUBLIC LIBRARY SCIENCE
    Citation
    Awah PK, Boock AU, Mou F, Koin JT, Anye EM, Noumen D, et al. (2018) Developing a Buruli ulcer community of practice in Bankim, Cameroon: A model for Buruli ulcer outreach in Africa. PLoS Negl Trop Dis 12(3): e0006238. https://doi.org/10.1371/journal.pntd.0006238
    Journal
    PLOS NEGLECTED TROPICAL DISEASES
    Rights
    © 2018 Awah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Background In the Cameroon, previous efforts to identify Buruli ulcer (BU) through the mobilization of community health workers (CHWs) yielded poor results. In this paper, we describe the successful creation of a BU community of practice (BUCOP) in Bankim, Cameroon composed of hospital staff, former patients, CHWs, and traditional healers. Methods and principle findings All seven stages of a well-defined formative research process were conducted during three phases of research carried out by a team of social scientists working closely with Bankim hospital staff. Phase one ethnographic research generated interventions tested in a phase two proof of concept study followed by a three-year pilot project. In phase three the pilot project was evaluated. An outcome evaluation documented a significant rise in BU detection, especially category I cases, and a shift in case referral. Trained CHW and traditional healers initially referred most suspected cases of BU to Bankim hospital. Over time, household members exposed to an innovative and culturally sensitive outreach education program referred the greatest number of suspected cases. Laboratory confirmation of suspected BU cases referred by community stakeholders was above 30%. An impact and process evaluation found that sustained collaboration between health staff, CHWs, and traditional healers had been achieved. CHWs came to play a more active role in organizing BU outreach activities, which increased their social status. Traditional healers found they gained more from collaboration than they lost from referral. Conclusion/Significance Setting up lines of communication, and promoting collaboration and trust between community stakeholders and health staff is essential to the control of neglected tropical diseases. It is also essential to health system strengthening and emerging disease preparedness. The BUCOP model described in this paper holds great promise for bringing communities together to solve pressing health problems in a culturally sensitive manner.
    ISSN
    1935-2735
    PubMed ID
    29584724
    DOI
    10.1371/journal.pntd.0006238
    Version
    Final published version
    Sponsors
    Optim us Foundation as part of the Stop Buruli Initiative
    Additional Links
    http://dx.plos.org/10.1371/journal.pntd.0006238
    http://dx.plos.org/10.1371/journal.pntd.0006238.g001
    http://dx.plos.org/10.1371/journal.pntd.0006238.g002
    http://dx.plos.org/10.1371/journal.pntd.0006238.t001
    http://dx.plos.org/10.1371/journal.pntd.0006238.t002
    http://dx.plos.org/10.1371/journal.pntd.0006238.t003
    http://dx.plos.org/10.1371/journal.pntd.0006238.t004
    http://dx.plos.org/10.1371/journal.pntd.0006238.t005
    http://dx.plos.org/10.1371/journal.pntd.0006238.t006
    http://dx.plos.org/10.1371/journal.pntd.0006238.t007
    http://dx.plos.org/10.1371/journal.pntd.0006238.s001
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