Fig 1.
Study flow chart: interaction between household- and health services-based surveys and wound management study.
Patients identified in the household- and health services-based surveys were offered to participate in the wound management study. The wound management study was carried out at three levels, in the community (community health workers—CHWs), health centre and district hospital according to the capability of the various levels and with the aim to identify and treat wounds as early as possible. The health staff of all three levels were trained in identifying, classifying, and treating wounds. W1 and W2: Training workshops (W) of nurses, assistant nurses, and CHWs; On-site training. IC1 and IC2: Informed consent (IC) for cross-sectional study and wound management study, respectively.
Fig 2.
Enrolment of wound events into the wound management study during household- and health services-based surveys.
Wound event was defined as an injury (e.g. mechanical trauma, burn, animal bite) or a specific pathology (e.g. BU, yaws) leading to one or multiple wounds. Wounds enrolled on the same date and attributed to the same aetiology were considered as one wound event. Specific aetiologies, such as BU or yaws, that could lead to multiple wounds over time were considered a single wound event. For details see [13].
Table 1.
Study endpoints for wounds stratified by main aetiology (confirmed diagnosis).
Fig 3.
Representative images of the wounds treated within the study stratified by health service level.
In the large subgroups “Primarily treated in the community” (N = 387) and “Primarily treated in AHC” (N = 510) the images were randomly selected to rule out selection bias. Multiple pictures are shown for patients with complicated wounds. Abbreviations in the square boxes indicate the wound aetiology: Fu = furuncle (ulcerated), T = Mechanical trauma, BU = Buruli Ulcer, LF = Late-stage lymphatic filariasis, ChU = Chronic wound of unknown origin. AHC: Ahondo Health Centre; WMU: Wound Management Unit. * = Number of wounds.
Table 2.
Study endpoints for wounds stratified by health service level.