ASSESSMENT OF KNOWLEDGE, ATTITUDE AND PRACTICES OF COMMUNITIES REGARDING BURULI ULCER INFECTION IN PARTS OF IMO STATE, NIGERIA

Knowledge, attitude and practices of communities regarding buruli ulcer infection in parts of Imo State, Nigeria were investigated in this study. A cross-sectional design involving interview with Household Heads in twenty villages and six focus group discussions were applied in 2018. Systematic sampling technique was adopted and a semi structured interviewer-administered questionnaire (validated and reliable) was the key instrument for data collection. The residents were physically examined for buruli ulcer disease and relationships with knowledge, attitude and practices were sought. The result of the reliability test showed that the instrument for data collection was highly reliable. In the study, respondents of age 56-65 years (14.0%) were more likely to think that buruli ulcer is not a health problem; instead it was as a consequence of the gods bewitching a person. Respondents with tertiary education qualification 124 (10.33%) were likely to regard buruli ulcer as a health-related challenge. Respondents who were traders 592 (49.33%) had the highest level of awareness. It was revealed that 96.67% knew about buruli ulcer, 5.83% of them knew it through the media and 9.35% knew it through Hospital Community Members. A total of 480 respondents (40%) attributed the disease to witchcraft, 10.83% perceived it was through insect bites and 23.75% believed it occurs due to lack of hygiene. Indigenous assessment showed that the disease has local names (out-ore; acha-ere) which reflect patterns of resistance and deterioration associated with the disease. Much negative behaviour about buruli ulcer was identified in the communities during the assessment. The findings of the study further showed that many individuals had knowledge about the disease but did not know how to manage the disease, particularly, their attitudes, practices and the way to manage the wound. The study also revealed that the women had difficulties accessing healthcare and therefore, the pains associated with wound management especially during routine-dressing was a serious challenge in the communities as patients were reluctant to visit hospitals for proper management due to overwhelming pains. The attitude and practice culminated in poor clinical management of the disease and invariably was responsible for the high prevalence rate of buruli ulcer in parts of Imo State, Nigeria. Community survey revealed that not much people knew about the mode of transmission and this deficiency limited adoption of preventive measures in the localities. Our study confirmed that buruli ulcer usually affects poor people in remote rural areas with limited access to health care. Our study also confirmed that most ulcers occur on the extremities; lesions on the lower extremities are almost twice as common as those on the upper extremities. Based on the outcome of this study, there should be capacity building and infrastructural facilities for handling of buruli ulcer emergency cases in Imo State, Nigeria. Quality health care facilities should be upgraded to adequately cope with buruli ulcer. Vigorous buruli ulcer sensitisation and awareness in communities, its implications, manifestations, signs and symptoms throughout Imo State, should be conducted. There is a need for more research to be carried out as mode of transmission of buruli ulcer diseases is still unknown. Buruli ulcer cases should be referred to qualified physicians to prevent wound severe infections and deterioration. There should be health education towards the misconceptions about the disease in the communities. Concerned authorities should be used in the treatment of buruli ulcer to avoid drug resistance by the wound-infecting microorganisms.