交叉的文化信仰和结构性障碍：尼日利亚伊莫州布鲁里溃疡的求医情况

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2026-01-01 Epub Date: 2025-12-31 DOI:10.1016/j.cegh.2025.102283

Chigozie Divine Onwuka , Evangeline Tochi Oparaocha

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引用次数: 0

摘要

问题由溃疡分枝杆菌引起的布鲁里溃疡是尼日利亚部分地区流行的一种被忽视的热带病。尽管它对公共卫生有影响，但对农村社区的求医行为仍然知之甚少，这限制了有针对性的干预措施。方法采用横截面混合方法对伊莫州4例地方性lga进行研究。使用结构化问卷从300名受访者中收集定量数据，同时通过对患者和护理人员的30次深度访谈、对传统治疗师的12次访谈、对卫生工作者的9次关键信息提供者访谈和7次焦点小组讨论产生定性数据。定量分析采用描述性统计和逻辑回归，定性记录采用社会生态模型进行主题分析。结果只有27.4%的受访者在症状出现两周内寻求生物医学治疗，而34.7%的受访者首先咨询传统治疗师。延迟就诊与受教育程度低（AOR = 2.14; 95% CI: 1.4-3.8）、信仰精神因果关系（AOR = 1.88; 95% CI: 1.1-3.3）、居住距离最近的医疗机构超过5公里（AOR = 1.76; 95% CI: 1.5-4.5）以及缺乏医疗保险（AOR = 1.54; 95% CI: 1.1-2.8）有关。定性数据显示精神解释、贫困、性别不平等、耻辱和对卫生设施的不信任是障碍。结论伊莫州布鲁里溃疡的求医受到文化信仰和结构性障碍的交叉制约。干预措施应结合文化敏感教育、减少污名、财务保护和分散服务提供，以改善及时获得护理的机会。

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Intersecting cultural beliefs and structural barriers: Healthcare-Seeking for buruli ulcer in Imo State, Nigeria

Problem

Buruli ulcer (BU), caused by Mycobacterium ulcerans, is a neglected tropical disease endemic to parts of Nigeria. Despite its public health impact, healthcare-seeking behavior in rural communities’ remains poorly understood, limiting targeted interventions.

Methods

A cross-sectional mixed-methods study was conducted in four endemic LGAs of Imo State. Quantitative data were collected from 300 respondents using structured questionnaires, while qualitative data were generated through 30 in-depth interviews with patients and caregivers, 12 interviews with traditional healers, 9 key informant interviews with health workers, and 7 focus group discussions. Quantitative analysis employed descriptive statistics and logistic regression, while qualitative transcripts were analyzed thematically using the Socio-Ecological Model

Results

Only 27.4 % of respondents sought biomedical care within two weeks of symptom onset, while 34.7 % consulted traditional healers first. Delayed hospital presentation was associated with low education (AOR = 2.14; 95 % CI: 1.4–3.8), belief in spiritual causation (AOR = 1.88; 95 % CI: 1.1–3.3), residing more than 5 km from the nearest health facility (AOR = 1.76; 95 % CI: 1.5–4.5), and lack of health insurance (AOR = 1.54; 95 % CI: 1.1–2.8). Qualitative data revealed spiritual interpretations, poverty, gender inequities, stigma, and mistrust of health facilities as barriers

Conclusion

Healthcare-seeking for BU in Imo State is constrained by the intersection of cultural beliefs and structural barriers. Interventions should combine culturally sensitive education, stigma reduction, financial protection, and decentralized service delivery to improve timely access to care.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.