“ < i > Buruli ulcer and leprosy < /i > , < i > they are intertwined < /i > ”: Patient experiences of integrated case management of skin neglected tropical diseases in Liberia

by Mateo Prochazka, Joseph Timothy, Rachel Pullan, Karsor Kollie, Emerson Rogers, Abednego Wright, Jennifer Palmer BackgroundSkin neglected tropical diseases (NTDs) such as Buruli ulcer (BU) and leprosy produce significant stigma and disability. Shared clinical presentations and needs for care present opportunities for integrated case management in co-endemic areas. As global policies are translated into local integrated services, there remains a need to monitor what new configurations of care emerge and how individuals experience them. MethodsTo explore patient experiences of integrated case management for skin NTDs, in 2018, we conducted a field-based qualitative case series in a leprosy rehabilitation centre in Ganta, Liberia where BU services were recently introduced. Twenty patients with BU (n = 10) and leprosy (n = 10) participated in in-depth interviews that incorporated photography methods. We contextualised our findings with field observations and unstructured interviews with health workers. FindingsThe integration of care for BU and leprosy prompted new conceptualisations of these diseases and experiences of NTD stigma. Some patients felt anxiety about using services because they feared being infected with the other disease. Other patients viewed the two diseases as ‘intertwined’: related manifestations of the same condition. Configurations of inter-disease stigma due to fear of transmission were buffered by joint health education sessions which also appeared to...
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research