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PLoS One. 2015 Jun 1;10(6):e0119926. doi: 10.1371/journal.pone.0119926. eCollection 2015.

Pain Associated with Wound Care Treatment among Buruli Ulcer Patients from Ghana and Benin.

Author information

1
Department of Health Psychology, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.
2
Department of Internal Medicine, Infectious Diseases Service, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
3
Programme de Lutte Contre la Lèpre et l'Ulcère de Buruli, Ministries of Health, Cotonou, Bénin.
4
Agogo Presbyterian Hospital, Agogo, Ghana.
5
Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
6
Department of Public Health, University Medical Center Groningen, University of Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands.

Abstract

Buruli ulcer (BU) is a necrotizing skin disease caused by Mycobacterium ulcerans. People living in remote areas in tropical Sub Saharan Africa are mostly affected. Wound care is an important component of BU management; this often needs to be extended for months after the initial antibiotic treatment. BU is reported in the literature as being painless, however clinical observations revealed that some patients experienced pain during wound care. This was the first study on pain intensity during and after wound care in BU patients and factors associated with pain. In Ghana and Benin, 52 BU patients above 5 years of age and their relatives were included between December 2012 and May 2014. Information on pain intensity during and after wound care was obtained during two consecutive weeks using the Wong-Baker Pain Scale. Median pain intensity during wound care was in the lower range (Mdn = 2, CV = 1), but severe pain (score > 6) was reported in nearly 30% of the patients. Nevertheless, only one patient received pain medication. Pain declined over time to low scores 2 hours after treatment. Factors associated with higher self-reported pain scores were; male gender, fear prior to treatment, pain during the night prior to treatment, and pain caused by cleaning the wound. The general idea that BU is painless is incorrect for the wound care procedure. This procedural pain deserves attention and appropriate intervention.

PMID:
26030764
PMCID:
PMC4451111
DOI:
10.1371/journal.pone.0119926
[Indexed for MEDLINE]
Free PMC Article

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