The socioeconomic burden of Buruli Ulcer disease in the Ga West District of Ghana

Abstract

Buruli ulcer (BU) is the third most common mycobacterial infection in humans after tuberculosis and leprosy. We highlight the social and economic burden of 86 BU patients studied in a Ghanaian district in 2008 which has the fifth highest BU prevalence rate in the country and is the most endemic in the Greater Accra Region. We traced patients who had received treatment for BU within the year preceding the study and interviewed them or the primary caretakers of minors mostly using a semi-structured interview guide. We found that against a background of living in abject poverty, the affected households spent on average over 80 per cent of their annual incomes on seeking health care for the disease despite the policy of free treatment for BU in government health care institutions. Beyond the direct financial costs, households incurred huge social and psychological burdens such as social stigma, isolation, and even divorce. Labor time lost due to care-seeking came close to one year for some affected patients. The extent of the burden from the disease had a relationship with care seeking patterns for the disease. We recommend that BU affected households be enrolled in the social protection programs of Ghana.

KEY WORDS: Buruli ulcer, socioeconomic burden, stigma, poverty, Ghana