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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 | Contractile responses to human urotensinⅡin rat and human pulmonary arteries: effect of endothelial factors and chronic hypoxia in the rat显示文摘 | Maclean M R Alexander D Atirrat A | 2000 | Br J Pharmacol2000，130，2： | 2 |
| 3 | 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 |
| 4 | Proliferation and signal- ing in fibroblasts : Role of 5-hydroxytryptamine receptor and trans- porter 显示文摘 | Welsh D J Harnett M MacLean M | 2004 | Am J Respir Crit Care Med2004，1170，3： | 1 |
| 5 | Anabolic and catabolic mRNA levels of the intervertebral disc vary with the magnitude and frequency of in vivo dynamic compression 显示文摘 | Maclean JJ Lee CR Alini M | 2004 | J Orthop Res2004，22，6： | 1 |
| 6 | Phylogenetic relationships between some members of the genera Neisseria , Acinetobacter, Moraxella , and Kingella based on partial 16S ribosomal DNA sequence analysis显示文摘 | ENRIGHT M C CCARTER P E MACLEAN I A | 1994 | Int J Syst Bacteriol1994，44，3： | 1 |
| 7 | Growth performance of transgenic tilapia containing an exogenous piscine growth hormone gene 显示文摘 | Rahman M A Maclean N | 1999 | Aquaculture1999，173，： | 1 |
| 8 | Parabolic shape of a tapered fused coupler-comparison with experiment显示文摘 | RODRIGUES J M P MACLEAN T S M GAZEY B K | 1987 | Applied Optics1987，26，9： | 1 |
| 9 | Women childhood experience of parental separation and their subsequent health and so- cioeconomic status in adulthood 显示文摘 | Kuh D Maclean M | 1990 | Journal of Bioso- cial Science1990，22，： | 1 |
| 10 | Experimental myocardial infarction in the rat显示文摘 | FISHBEIN M C MACLEAN D MAROKO P R | 1978 | Am J Pathol1978，90，1： | 1 |
| 11 | Gwemline transmission and expression of a lacZ containing transgene in tilapia (Oreochromis niloticus)显示文摘 | Alam M S Popplewell A Maclean N | 1996 | Transgenic Res1996，5，： | 1 |
| 12 | Chronic hypoxia induces constitutive p38 mitogen-activated protein kinase activity that correlates with enhanced cellular proliferation in fibroblasts from rat pulmonary but not systemic arteries显示文摘 | Welsh D J Peacock A J MacLean M | 2001 | Am J Respir Crit Care Med2001，164，2： | 1 |
| 13 | Mitochondrial DNA se-quence divergence among lycopersicon and related solanum species显示文摘 | MACLEAN P E HANSON M R | 1986 | Genetics1986，112，： | 1 |
| 14 | 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 |
| 15 | Growth performance of transgenic tilapia containing an exogenous piscine growth hormone gene显示文摘 | Rahman M A Maclean N | 1999 | Aquaculture1999，173，： | 1 |
| 16 | Sys- tematic review:comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis 显示文摘 | MACLEAN C NEWBERRY S MAGLIONE M | 2008 | Ann Intern Med2008，148，3： | 1 |
| 17 | Study of direct-measur- ing skin-friction gauge with rubber sheet for damping显示文摘 | Magill S MacLean M Schetz J | 2002 | AIAA Journal2002，40，1： | 1 |
| 18 | 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 |
| 19 | CCD noise removal in digital image显示文摘 | Faraji H MacLean M J | 2006 | IEEE Transactions on Image Processing2006，15，9： | 1 |
| 20 | 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 |
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