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What Role Do Traditional Beliefs Play in Treatment Seeking and Delay for Buruli Ulcer Disease?–Insights from a Mixed Methods Study in Cameroon

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  • Koen Peeters Grietens
  • Elizabeth Toomer
  • Alphonse Um Boock
  • Susanna Hausmann-Muela
  • Hans Peeters
  • Kirezi Kanobana
  • Charlotte Gryseels
  • Joan Muela Ribera

Abstract

Background: Victims of Buruli ulcer disease (BUD) frequently report to specialized units at a late stage of the disease. This delay has been associated with local beliefs and a preference for traditional healing linked to a reportedly mystical origin of the disease. We assessed the role beliefs play in determining BUD sufferers’ choice between traditional and biomedical treatments. Methods: Anthropological fieldwork was conducted in community and clinical settings in the region of Ayos and Akonolinga in Central Cameroon. The research design consisted of a mixed methods study, triangulating a qualitative strand based on ethnographic research and quantitative data obtained through a survey presented to all patients at the Ayos and Akonolinga hospitals (N = 79) at the time of study and in four endemic communities (N = 73) belonging to the hospitals’ catchment area. Results: The analysis of BUD sufferers’ health-seeking behaviour showed extremely complex therapeutic itineraries, including various attempts and failures both in the biomedical and traditional fields. Contrary to expectations, nearly half of all hospital patients attributed their illness to mystical causes, while traditional healers admitted patients they perceived to be infected by natural causes. Moreover, both patients in hospitals and in communities often combined elements of both types of treatments. Ultimately, perceptions regarding the effectiveness of the treatment, the option for local treatment as a cost prevention strategy and the characteristics of the doctor-patient relationship were more determinant for treatment choice than beliefs. Discussion: The ascription of delay and treatment choice to beliefs constitutes an over-simplification of BUD health-seeking behaviour and places the responsibility directly on the shoulders of BUD sufferers while potentially neglecting other structural elements. While more efficacious treatment in the biomedical sector is likely to reduce perceived mystical involvement in the disease, additional decentralization could constitute a key element to reduce delay and increase adherence to biomedical treatment.

Suggested Citation

  • Koen Peeters Grietens & Elizabeth Toomer & Alphonse Um Boock & Susanna Hausmann-Muela & Hans Peeters & Kirezi Kanobana & Charlotte Gryseels & Joan Muela Ribera, 2012. "What Role Do Traditional Beliefs Play in Treatment Seeking and Delay for Buruli Ulcer Disease?–Insights from a Mixed Methods Study in Cameroon," PLOS ONE, Public Library of Science, vol. 7(5), pages 1-8, May.
  • Handle: RePEc:plo:pone00:0036954
    DOI: 10.1371/journal.pone.0036954
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    References listed on IDEAS

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    1. Joan Muela Ribera & Koen Peeters Grietens & Elizabeth Toomer & Susanna Hausmann-Muela, 2009. "A Word of Caution against the Stigma Trend in Neglected Tropical Disease Research and Control," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(10), pages 1-4, October.
    2. Koen Peeters Grietens & Alphonse Um Boock & Hans Peeters & Susanna Hausmann-Muela & Elizabeth Toomer & Joan Muela Ribera, 2008. "“It Is Me Who Endures but My Family That Suffers”: Social Isolation as a Consequence of the Household Cost Burden of Buruli Ulcer Free of Charge Hospital Treatment," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 2(10), pages 1-7, October.
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    1. Giles-Vernick, Tamara & Owona-Ntsama, Joseph & Landier, Jordi & Eyangoh, Sara, 2015. "The puzzle of Buruli ulcer transmission, ethno-ecological history and the end of “love” in the Akonolinga district, Cameroon," Social Science & Medicine, Elsevier, vol. 129(C), pages 20-27.
    2. Susan Dierickx & Julie Balen & Chia Longman & Ladan Rahbari & Ed Clarke & Bintou Jarju & Gily Coene, 2019. "‘We are always desperate and will try anything to conceive’: The convoluted and dynamic process of health seeking among women with infertility in the West Coast Region of The Gambia," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-20, January.

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