Analyzing the Experiences of Buruli Ulcer Disease Patients in Nigeria Using the Socioecological Model of Health: A Qualitative Cross-Sectional Study

Abstract

Introduction Buruli Ulcer Disease (BUD) is a debilitating neglected tropical disease caused by “Mycobacterium ulcerans”, predominantly affecting marginalized populations in tropical and subtropical regions, including Nigeria. This study utilizes the socioecological model of health to explore the complex interplay of individual, interpersonal, community, and societal factors shaping the experiences of BUD patients in Nigeria. Previous research has primarily focused on biomedical aspects, often neglecting the sociocultural and environmental dimensions crucial to patient experiences and outcomes.Methods A qualitative cross-sectional descriptive research design was employed, focusing on selected BUD endemic communities in Enugu State, Nigeria. Ethical approval was obtained from the Enugu State University Teaching Hospital’s Research and Ethics Committee. Data collection involved one Focus Group Discussion (FGD) with eight discussants and six Key Informant Interviews (KII), encompassing a diverse group of BUD patients. The WHO Quality of Life-BREF was adapted for data collection, which was conducted by a trained team. Data were analyzed using content analysis to inductively code themes and identify overarching categories.Results At the individual level, participants reported significant physical and psychological impacts, including pain, discomfort, disfigurement, and stigmatization. Interpersonal experiences highlighted social rejection, loss of social roles, and abandonment by family members. Organizational challenges included job loss, reduced productivity, and financial dependence, while community-level experiences ranged from supportive actions to social isolation and discrimination. Participants noted a lack of comprehensive community support, often exacerbated by misconceptions about the disease.Conclusion BUD patients in Nigeria endure considerable negative psychosocial experiences, particularly at the interpersonal and community levels. Enhancing community awareness and support is crucial to mitigating these impacts. Further research should explore family-level psychosocial experiences and other contributing factors to provide a more comprehensive understanding and inform effective intervention strategies.