Community Knowledge, Attitudes and Perceptions Regarding Buruli Ulcer in Bafia Health District, Centre Region-Cameroon

Abstract

Aim: Buruli ulcer (BU), a neglected tropical disease, occurs in about thirty-three countries world-wide. Misconceptions about BU leads to poor health-seeking behaviors. We explored community knowledge, perceptions and attitudes regarding BU in a new endemic district. Study Design: It was a cross-sectional community-based survey. Place and Duration of Study: Bafia Health District (BHD), Centre region of Cameroon, in between November 2023 and February 2024. Methodology: We recruited 1341 participants through a three-stage cluster sampling design. A structured questionnaire was administered to 2 or 3 members aged 10-87 years of each household visited. Descriptive statistics were performed, chi-square tests used to assess associations, and forward stepwise binary logistic regression models used to identify independently associated factors of attitudes. Results: Of 1341 participants, 30.1% had heard of and 21.1% knew someone with BU. Only 17.2% correctly identified BU lesions, 2.3% knew its cause, and 19.2% believed BU was curable. Regarding attitudes towards persons with BU (PWBU) only 27.4% would show them respect, 19,5% would shake hands, and 16.4% would share the same plate with them. Additionally, only 17.3% approved of their participation, and 14.1% and 12.2% respectively would allow their child to play with or marry a PWBU. Positive attitudes towards PWBU were significantly associated with: head about BU, knowing a PWBU, and understanding that BU is curable. Negative attitudes were significantly associated with beliefs that: BU is caused by supernatural forces, poor hygiene, or living with a PWBU. Conclusion: There were poor community knowledge and negative perceptions about BU in the BHD, which negatively influenced community attitudes towards PWBU. A community education intervention focusing on the natural occurrence, biological etiology, non-hereditary nature, the non-human-to-human transmission, and the curable nature of BU could improve upon the situation in BHD.