April 2011 | Benin, Cameroon, Ghana
After research about why patients delay seeking treatment or abandon it, the social science team of the Stop Buruli consortium has started to explore viable solutions for Buruli ulcer control. A workshop held in Limbe, Cameroon, in January discussed the country-specific situations and developed action plans for carrying out and assessing the feasibility of different interventions in Benin, Cameroon and Ghana.

If Buruli ulcer is treated early enough and with appropriate medicines the disease can be treated, thereby reducing irreversible disabilities and costly hospital stays. Late recognition of the disease and poor adherence to treatments pose serious problems to effective Buruli control. The results from earlier research on therapy-seeking have provided the basis for planning pilot interventions to improve treatment access and adherence. With this, the social science team now moved from the “why” to a “how” phase of action research.

In Benin, pilot projects seek to mobilize women's groups and former Buruli ulcer patients to assist in community-based support networks and early recognition of Buruli ulcer. Screeners, trained to identify patients who are less likely to take up treatment, help to understand patients' needs and address their concerns through counseling and other support. Feeding and lodging programs offer solutions for food shortage and accommodation problems encountered by patients and their families during prolonged hospital stays.

In Cameroon, the situation of extreme poverty and poor transportation systems justifies prioritization of decentralized health care and volunteer outreach programs, based on the establishment of a network of housing opportunities in remote villages connected to local health centers. Pilot projects will also test the feasibility of community support systems provided by women's groups and former patients.

Ghana has already started with a peer-to-peer intervention where former patients support newly diagnosed youth as they begin treatment. A school-to-clinic transport intervention helps children with Buruli ulcer to not miss school during the long therapies. New educational materials that focus on practical knowledge and treatment success, rather than on fear, are being developed.

In the coming months, the pilot projects will be documented and their outcomes evaluated. The plan is to identify the best interventions – or combinations of interventions – for each country. If feasibility and success can be shown, larger scale projects will be developed and implemented over the next two years.