Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa
Name:
journal.pntd.0006291.pdf
Size:
15.70Mb
Format:
PDF
Description:
Final Published version
Author
Amoussouhoui, Arnaud SetondjiSopoh, Ghislain Emmanuel
Wadagni, Anita Carolle
Johnson, Roch Christian
Aoulou, Paulin
Agbo, Inès Elvire
Houezo, Jean-Gabin
Boyer, Micah
Nichter, Mark
Affiliation
Univ Arizona, Sch AnthropolIssue Date
2018-03
Metadata
Show full item recordPublisher
PUBLIC LIBRARY SCIENCECitation
Amoussouhoui AS, Sopoh GE, Wadagni AC, Johnson RC, Aoulou P, Agbo IE, et al. (2018) Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa. PLoS Negl Trop Dis 12(3): e0006291. https://doi.org/10.1371/journal.pntd.0006291Journal
PLOS NEGLECTED TROPICAL DISEASESRights
© 2018 Amoussouhoui 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 Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care. Methodology/Principal findings We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. Conclusions/Significance This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control.ISSN
1935-2735PubMed ID
29529087Version
Final published versionSponsors
UBS Optimus Foundation (UBS-OF)Additional Links
http://dx.plos.org/10.1371/journal.pntd.0006291http://dx.plos.org/10.1371/journal.pntd.0006291.g001
http://dx.plos.org/10.1371/journal.pntd.0006291.g002
http://dx.plos.org/10.1371/journal.pntd.0006291.g003
http://dx.plos.org/10.1371/journal.pntd.0006291.g004
http://dx.plos.org/10.1371/journal.pntd.0006291.g005
http://dx.plos.org/10.1371/journal.pntd.0006291.g006
http://dx.plos.org/10.1371/journal.pntd.0006291.t001
http://dx.plos.org/10.1371/journal.pntd.0006291.t002
http://dx.plos.org/10.1371/journal.pntd.0006291.t003
ae974a485f413a2113503eed53cd6c53
10.1371/journal.pntd.0006291
Scopus Count
Collections
Except where otherwise noted, this item's license is described as © 2018 Amoussouhoui et al. This is an open access article distributed under the terms of the Creative Commons Attribution License.
Related articles
- Outcome of Streptomycin-Rifampicin treatment of Buruli Ulcer in two Ghanaian districts.
- Authors: Iddrisah FN, Yeboah-Manu D, Nortey PA, Nyarko KM, Anim J, Antara SN, Kenu E, Wurapa F, Afari EA
- Issue date: 2016
- Clinical outcomes of Ghanaian Buruli ulcer patients who defaulted from antimicrobial therapy.
- Authors: Klis S, Kingma RA, Tuah W, van der Werf TS, Stienstra Y
- Issue date: 2016 Sep
- The gendered impact of Buruli ulcer on the household production of health and social support networks: Why decentralization favors women.
- Authors: Agbo IE, Johnson RC, Sopoh GE, Nichter M
- Issue date: 2019 Apr
- Buruli ulcer in West Africa: strategies for early detection and treatment in the antibiotic era.
- Authors: Webb BJ, Hauck FR, Houp E, Portaels F
- Issue date: 2009 Aug
- Effectiveness of rifampicin-streptomycin for treatment of Buruli ulcer: a systematic review.
- Authors: Tanywe A, Fernandez RS
- Issue date: 2017 Jan