INTEGRATING INDIGENOUS PRACTICES WITH EVIDENCE-BASED CARE: A MIXED-METHODS INVESTIGATION OF BURULI ULCER TREATMENT DYNAMICS IN IMO STATE, NIGERIA”

Buruli Ulcer (BU), caused by Mycobacterium ulcerans, is still a major public health concern in West Africa, particularly in rural populations such as Imo State, Nigeria. Despite the availability of effective WHO-recommended antibiotic regimens, a significant minority of affected people continue to use traditional and unconventional therapeutic methods, often delaying access to biomedical care. This interaction between traditional beliefs and contemporary medicine poses both obstacles and opportunity for improving BU management in endemic areas. This study analyzes the treatment dynamics of BU in Imo State by looking at how indigenous approaches are integrated with evidence-based medical treatments. It seeks to comprehend patient health-seeking behaviors, cultural views of the condition, and the impact of these variables on therapeutic outcomes. A concurrent mixed-methods strategy was used, with 400 laboratory-confirmed BU patients spread throughout three endemic local government districts in Imo State. Structured questionnaires were used to obtain quantitative data on treatment options, duration of delays, lesion categorization, and treatment results. To capture cultural and belief-driven influences on treatment decisions, qualitative data were collected through focus group discussions and in-depth interviews with patients, traditional healers, and healthcare personnel. 78% of the individuals sought indigenous or spiritual therapies first, with a median delay of 12 weeks before obtaining orthodox care. In this group, 82% developed to advanced lesions (Category II or III). Patients who received evidence-based care promptly had significantly greater healing rates (95%) and decreased complication rates (p<0.01). Strong cultural views (65%), skepticism in biomedical systems (16%), and economic limitations (30%) were the primary factors motivating unorthodox treatment preferences. Notably, several traditional healers expressed a readiness to work with mainstream health care institutions if properly engaged and taught. The incorporation of culturally sensitive health education and the involvement of trustworthy indigenous practitioners offer a viable strategy for promoting early detection and adherence to successful BU treatment in Imo State. Bridging traditional and biological techniques has the potential to considerably reduce disease load and enhance health outcomes in endemic situations. Policy innovations that focus on community participation and cross-sector collaboration are critically needed.