02068nas a2200277   4500000000100000008004100001653003900042653001700081653002800098653002900126653001000155653002500165100001300190700001300203700001400216700001300230700001400243700001200257700001100269700001600280245013700296300001100433490000800444520132400452022001401776       2008                            d10aNeglected tropical diseases (NTDs)10aBuruli ulcer10aStigma (health related)10aHealth seeking behaviour10aBenin10aTraditional medicine1 aMulder A1 aBoerma R1 aBarogui Y1 aZinsou C1 aJohnson C1 aGbovi J1 aWerf T1 aStienstra Y00aHealthcare seeking behaviour for Buruli ulcer in Benin: a model to capture therapy choice of patients and healthy community members.  a912-200 v1023 a<p>Buruli ulcer is a devastating condition emerging in West Africa. We investigated why patients often report late to the hospital. Health seeking behaviour determinants and stigma were studied by in-depth interviews in patients treated in hospital (n=107), patients treated traditionally (n=46) of whom 22 had active disease, and healthy community control subjects (n=107). We developed a model capturing internal and external factors affecting decision making. With increasing severity, extent and duration of Buruli ulcer, a shift of influencing factors on health seeking behaviour appears to occur. Factors causing delay in presenting to hospital were the use of traditional medicine before presenting at the treatment centre; costs and duration of admission; disease considered not serious enough; witchcraft perceived as the cause of disease; and fear of treatment, which patients expected to be amputation. This study confirms the importance of self-treatment and traditional healing in this area. Our study was performed before antimicrobial treatment was introduced in Benin; we suggest that this model and the results from this analysis should be used as a baseline from which to measure the influence of the introduction of antimicrobial treatment on health seeking behaviour for Buruli ulcer in Benin.</p>
  a0035-9203