17 April 2010

The consortium welcomes Dr. Mark Nichter, an American anthropologist based at the University of Arizona, USA, as a new member of the Stop Buruli initiative. With Mark Nichter as the lead on socio-economic and cultural aspects, the consortium strengthens and deepens its research focus in social sciences. Socioeconomic and cultural factors like poverty not only allow pathogens that cause infectious diseases to take advantage of their environment and to spread, but they also make it hard for effective control measures to be implemented. Thus, social science research is key to all aspects of infectious disease surveillance and management.

At the moment, Nichter is preparing to embark on research covering the following topics:

• Healthcare-seeking delay
• Outpatient treatment drop-out and non-compliance rates
• Effectiveness of health volunteers and possible use of traditional practitioners in early identification of BU
• Direct, indirect, opportunity and social costs of seeking Buruli treatment
• Decentralized Buruli care and research staff suggestions on how to enhance effectiveness and sustain staff morale

Based on baseline data, studies involving pilot interventions which aim to decrease treatment delay and non-compliance will be conducted through strategic support of patients and clinic staff. These studies are expected to begin a year from now.

Read more about Mark Nichter

Interview with Mark Nichter:

What was your motivation to join the Stop Buruli initiative?
Besides my keen interest in infectious diseases, a mix of factors has compelled me to become involved: the degree of patient suffering, the lack of and very clear need for social science research, and the strong motivation of in-country researchers. Also, this disease, from an epidemiological point of view, is very puzzling. I like a good puzzle.

What contribution can be expected from the social science aspect?
Our formative research will contribute to the transmission, disease identification, and treatment axis of the initiative. As somebody who has worked on tuberculosis (TB) for many years, I am also very concerned about the potential for drug resistance. If we are using a drug like Rifampicin, decentralized treatment demands a high degree of adherence. We must be attentive to this issue as it affects diseases beyond Buruli ulcer.

Do you see any challenges to work in a transdisciplinary and transnational team?
The challenges in the field will no doubt be significant; however, I am confident that we will proactively address them as best we can as there is a lot of respect among each of the research groups. We are learning to work together and harness our strengths via email communications and by holding workshops. We will use common research guides tailored to the unique circumstances of each cultural context, and are harmonizing research across the three country research sites.

Have you had similar experiences in projects like this?
I have considerable experience working as a medical anthropologist on infectious and vector-borne diseases in developing countries. I have significant experience working on and organizing transdisciplinary research teams: I have served as the social science advisor to the International Network for Clinical Epidemiology (INCLEN) for over 20 years, and I was a member of the USA Institute of Medicine Panel on Sustaining Global Surveillance and Response to Emerging Zoonotic Diseases.