Factors associated with functional limitations and subsequent employment or schooling in Buruli ulcer patients


Ymkje Stienstra (corresponding author), Margijske H. G. van Roest, Marieke J. van Wezel, Irene C. Wiersma, Ilona C. Hospers, P. U. Dijkstra, Winette T. A. van der Graaf, Tjip S. van der Werf, Groningen University Hospital, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Tel.: +31-50-3616161; Fax: +31-50-3613216; E-mail: y.stienstra@int.azg.nl, t.s.van.der.werf@int.azg.nl
R. Christian Johnson, Programme National de Lutte contre l'Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin. E-mail: rochjohnson@yahoo.fr
Edwin O. Ampadu, Ministry of Health, National Buruli ulcer Control Programme, Korle Bu Accra, Ghana. E-mail: yaatui@yahoo.com
Jules Gbovi, Centre de Santé, Unité de traitement des ulcères de Buruli, Lalo, Benin.
Claude Zinsou, Centre Sanitaire et Nutritionnel Gbemontin, Zagnanado, Benin. E-mail: claudezinsou@yahoo.fr
Samuel Etuaful, St Martin's Catholic Hospital, Agroyesum, Ghana. E-mail: sknetuaful@hotmail.com
Erasmus Y. Klutse, Dunkwa Governmental Hospital, Dunkwa, Ghana. E-mail: eyklutse@yahoo.com


Objectives  To evaluate former Buruli ulcer disease (BUD) patients to assess the factors associated with functional limitations and subsequent employment or schooling.

Methods  The previously validated Buruli ulcer functional limitation score (BUFLS) questionnaire and interviews about educational and professional consequences incurred by BUD.

Results  Of 638 participants, 362 (57%) had a functional limitation after a median period of almost 4 years after treatment for BUD. A lesion on a joint, older age, female gender, a lesion on a distal part of an extremity and a persistent wound were found to be independent risk factors for stopping work or education. The same risk factors applied to the development of a functional limitation. Both functional limitations and financial difficulties due to BUD disease often led to job loss and school dropout.

Conclusions  Rehabilitation programmes are urgently needed to diminish the suffering from the functional limitations and employment or schooling problems caused by BUD.