Suchergebnisse

Background Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care. Methodology/Principal findings We conducted intervention-oriented research implemented in four steps: baseline study, training of health district clinical staff, outreach education, outcome and impact assessments. Study results demonstrated that early BU lesions (71% of all detected cases) could be treated in the community following outreach education, and that most of the afflicted were willing to accept decentralized treatment. Ninety-three percent were successfully treated with antibiotics alone. The impact evaluation found that community confidence in decentralized BU care was greatly enhanced by clinic staff who came to be seen as having expertise in the care of most chronic wounds. Conclusions/Significance This study documents a successful BU outreach and decentralized care program reaching early BU cases not previously treated by a proactive centralized BU program. The pilot program further demonstrates the added value of integrated wound management for NTD control. ; UBS Optimus Foundation (UBS-OF) ; This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.

Frontmatter -- Contents -- Introduction -- Part One. Global Medicines in Local Cultures -- Chapter 1 Global Health Goals and Local Constraints in a Rural Peruvian Clinic -- Chapter 2 Science and Sanctity: Biomedicine and Christianity at an Ethiopian Hospital -- Chapter 3 The Cosmopolitan Hospital -- Chapter 4 "Dangerous Disease" Epilepsy in Asante -- Chapter 5 The Salience of the State in Biomedicine: Congo and Uganda Cases Compared -- Part Two. Care Giving and Hospital Labor -- Chapter 6 Creating a Therapeutic Community: Lessons from Allada Hospital Benin -- Chapter 7 Medical "Errands" among Women with Cervical Cancer in Guatemala -- Chapter 8 Routinized Caring or a "Call" to Nursing: Shifts in Hospital Nursing in Rukwa, Tanzania -- Chapter 9 "We Work with What We Have, Not with What We Would Like to Have" Hospital Care in Mexico -- Part Three. Hospitals and the Patient -- Chapter 10 The Navigation of Public Hospitals by West African Immigrants with Cancer in Paris, France -- Chapter 11 Each Child Is Unique: The Responsible U.S. Parent's Take on Hospital Care Gone Wrong -- Chapter 12 Making Ethnographic Sense of Cesarean Rates in Greek Public Hospitals -- Chapter 13 The Nightside of Medicine: Obstetric Suffering and Ethnographic Witnessing in a Pakistani Hospital -- Afterword -- References -- Notes on Contributors -- Index