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| 1 | Socio-cultural determinants of timely and delayed treatment of Buruli ulcer: implications for disease control显示文摘Introduction:Public health programmes recommend timely medical treatment for Buruli ulcer(BU)infection to prevent pre-ulcer conditions from progressing to ulcers,to minimise surgery,disabilities and the socio-economic impact of BU.Clarifying the role of socio-cultural determinants of timely medical treatment may assist in guiding public health programmes to improve treatment outcomes.This study clarified the role of socio-cultural determinants and health system factors affecting timely medical treatment for BU in an endemic area in Ghana.Methods:A semi-structured explanatory model interview based on the explanatory model interview catalogue(EMIC)was administered to 178 BU-affected persons.Based on research evidence,respondents were classified as timely treatment(use of medical treatment 3 months from awareness of disease)and delayed treatment(medical treatment 3 months after onset of disease and failure to use medical treatment).The outcome variable,timely treatment was analysed with cultural epidemiological variables for categories of distress,perceived causes of BU,outside-help and reasons for medical treatment in logistic regression models.The median time for the onset of symptoms to treatment was computed in days.Qualitative phenomenological analysis of respondents’narratives clarified the meaning,context and dynamic features of the relationship of explanatory variables with timely medical treatment.Results:The median time for initiating treatment was 25 days for pre-ulcers,and 204 days for ulcers.Income loss and use of herbalists showed significantly negative associations with timely treatment.Respondents’use of herbalists was often motivated by the desire for quick recovery in order to continue with work and because herbalists were relatives and easily accessible.However,drinking unclean water was significantly associated with timely treatment and access to health services encouraged timely treatment(OR 8.5,p=0.012).Findings show that health system factors of access are responsible for non-compliance to treatment regimes.Conclusions:Findings highlight the importance of an integrated approach to BU control and management considering the social and economic features that influence delayed treatment and factors that encourage timely medical treatment.This approach should consider periodic screening for early case-detection,collaboration with private practitioners and traditional healers,use of mobile services to improve access,adherence and treatment outcomes. | Mercy M Ackumey Margaret Gyapong Matilda Pappoe Cynthia Kwakye Maclean Mitchell G Weiss | 2012 | Infectious Diseases of Poverty2012，1，1： | 3 |
| 2 | Skeletal muscle sterol regulatory element binding protein-1c decreases with food deprivation and increases with feeding in rats显示文摘 | BIZEAU M E MACLEAN P S JOHNSON G C | 2003 | The Journal of Nutrition2003，133，： | 1 |
| 3 | Muscle glucose transporter (GLUT4) gene expression during exercise 显示文摘 | Maclean P S Zheng D Dohm G L | 2001 | Exerc Sport Sci Rev2001，28，： | 1 |
| 4 | Backwashing First-stage Sand-BAC Filters显示文摘 | Patrick Niquette Michele Prevost Robert G Maclean | 1998 | Jour AWWA1998，90，1： | 1 |
| 5 | Contribution of Nitric Oxide Synthase 1,2, &3to Airway Responsiveness in a Murine Model of Allergic Asthma显示文摘 | DeSanctis G T Maclean A Hamada K | | Am J Respir Crit Care Med0，159，： | 1 |
| 6 | Overexpression of the 5-hydroxytryptamine transporter gene:effect on pulmonary hemodynamics and hypoxiainduced pulmonary hypertension显示文摘 | MACLEAN M R DEUCHAR G A HICKS M N | 2004 | Circulation2004，109，17： | 1 |
| 7 | Accuracy of positron emission tomography for diagnosis of pul monary nodules and mass lesions显示文摘 | GOULD M K MACLEAN C C KUSCHNER W G | 2001 | JAMA2001，285，8： | 1 |
| 8 | Expediting the development of targeted SRM assays:using data from shotgun proteomics to automate method development显示文摘 | Prakash A Tomazela D M Frewen B Maclean B Merrihew G Peterman S Maccoss M J | | 0，，： | 1 |
| 9 | A Comparison of Canonical Discriminant Analysis and Principal Component Analysis for Spectral Transformation显示文摘 | Zhao G Maclean A L | 2000 | Photogrammetric Engineering&Remote Sensing2000，66，7： | 1 |
| 10 | The challenge of preparing and enabling'skilled at-tendants to promote safer hildbirth显示文摘 | MaClean G D | | 0，，03： | 1 |
| 11 | Accuracy of positron emission tomography for diagnosis of pulmonary nodules and mass lesions:a meta-analysis显示文摘 | GOULD M K MACLEAN C C KUSCHNER W G | 2001 | JAMA2001，285，7： | 1 |
| 12 | Accuracy of position emission tomography for diagnosis of pulmonary nodules and mass lesions: a meta-analysis 显示文摘 | Gould M K Maclean C C Kuschner W G | 2001 | JAMA2001，285，7： | 1 |
| 13 | Argillite debris converted to bauxite during karst weathering: evidence from immobile element geochemistry at the Olmedo Deposit, Sardinia 显示文摘 | MACLEAN W H BONAVIA F F SANNA G | 1997 | Mineralium Deposita1997，32，： | 1 |
| 14 | Accurary of positron emission tomography for diagnosis of pulmonary nodules and mass lesions显示文摘 | Gould M K Maclean C C Kuschner W G | 2001 | JAMA2001，285，7： | 1 |
| 15 | Evaluating the performance of continuous flow biofilm reactors for the rapid determination of biodegradable dissolved organic carbon in drinking water显示文摘 | MacLean R G Prevost M Niquette P | 1997 | Environmental Technology1997，17，： | 1 |
| 16 | Capital Growth with Security显示文摘 | Sanegre R Zhao Y G | 2004 | Journal of Economic Dynamics & Control2004，28，5： | 1 |
| 17 | Overexpression of the 5-hydroxytryptamine transporter gene: effect on pulmonary hemodynamics and hypoxia-induced pulmonary hypertension显示文摘 | MacLean M R Deuchar G A Hicks M N | 2004 | Circulation2004，109，17： | 1 |
| 18 | Recombinant ovine interferon-gamma inhibits the multiplication of Chlamydia psittaei in ovine cells显示文摘 | Graham S P Jones G E Maclean M | 1995 | J Comp Pathol1995，112，2： | 1 |
| 19 | Acove Quality Indicators显示文摘 | Shekelle P G Maclean C H Morton S C | 2001 | Ann Intern bled2001，135，82： | 1 |
| 20 | Thymosin beta 4 sulfoxide is an anti-inflammatory agent generated by monocytes in the presence of glucocorticoids显示文摘 | Young J D Lawrence A J Maclean A G | 1999 | Nat Med1999，5，12： | 1 |
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