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DEVELOPMENT OF A QUESTIONNAIRE ASSESSING BURULI ULCER–INDUCED FUNCTIONAL LIMITATION

Buruli ulcer, a disease with long-term consequences, is emerging in west Africa. Thus, a functional limitation scoring system is needed to assess its nature and severity. A list of daily activities was developed for this disease. Following treatment of Buruli ulcer, persons in Benin (n = 47) and Ghana (n = 41) were investigated. Nineteen items were identified with good internal consistency. Participants (median age = 14 years) could not perform 23% of their daily activities. Twenty-nine participants did not have any functional limitation. The average limitation score was 31% in Benin and 15% in Ghana (P = 0.006). The mean limitation score in participants without visible contractures (n = 65) was 13%, whereas patients with visible contractures (n = 20) or an amputation (n = 3) had a score of more than 50%. Validity and reliability should be further analyzed to optimize the scale for use in individual evaluation, as an end point in intervention trials, and in planning of resources needed for the care of patients with functional limitations.

Received May 30, 2003. Accepted for publication October 1, 2003.

Acknowledgments: We thank Kabiru Mohammed Abass, Adrian Hadjindé, and Médecins Sans Frontières in Lalo, Benin for their help with this study.

Financial support: This research was supported by the BuG Foundation, the Groningen University Institute for Drug Exploration (GUIDE), the Dutch Organization for Scientific Research (NOW), and the Royal Dutch Academy of Arts and Science-van Walree Foundation.

Authors’ addresses: Ymkje Stienstra, Winette T. A. van der Graaf, and Tjip S. van der Werf, Department of Internal Medicine, Groningen University Hospital, PO Box 30.001, 9700 RB Groningen, The Netherlands, Fax: 31-50-361-3216, E-mails: y.stienstra{at}int.azg.nl and t.s.van.der.werf{at}int.azg.nl. Pieter U. Dijkstra, Department of Rehabilitation, Groningen University Hospital, PO Box 30.001, 9700 RB Groningen, The Netherlands. Augustin Guédénon, Programme National de Lutte contre l’Ulcère de Buruli, Ministère de la Santé Publique, Cotonou, Benin. Christian R. Johnson, Centre de Santé, Unité de Traitement des Ulcères de Buruli, Lalo, Benin. Edwin O. Ampadu, National Buruli Ulcer Control Program, Ministry of Health, Korle Bu Accra, Ghana. Thomas Mensah, Agogo Presbyterian Hospital, Agogo, Ghana. Erasmus Y. Klutse, Dunkwa Governmental Hospital, Dunkwa, Ghana. Samual Etuaful, St. Martin’s Catholic Hospital, Agroyesum, Ghana. Sunil Deepak, Associazione Italiana Amici di Raoul Follereau, Bologna, Italy.

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