{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:33:38Z","timestamp":1790634818944,"version":"4.1.0"},"reference-count":26,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003042","name":"Else Kr\u00f6ner-Fresenius-Stiftung","doi-asserted-by":"publisher","award":["2017_HA19"],"award-info":[{"award-number":["2017_HA19"]}],"id":[{"id":"10.13039\/501100003042","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Wounds are a neglected health problem in rural communities of low-income countries, mostly caused by trauma and ulcerative skin diseases including Neglected Tropical Diseases (NTDs) and associated with systemic complications and disability. Rural communities have limited access to high quality health services-based wound care.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a prospective observational study on wound management at three levels\u2013community (C), health centre (HC), district hospital (DH)\u2014in a rural community of C\u00f4te d\u2019Ivoire. Patients with skin wounds actively identified in a house-to-house survey and passively in the health services in a defined area of the Taabo Health and Demographic Surveillance System were asked to participate and followed-up longitudinally. Endpoints were proportion of wounds closed, time to wound closure, wound size over time, frequency of secondary bacterial infection, need for recapturing after follow-up interruption, and duration of treatment stratified by health service level and wound aetiology.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We enrolled 561 patients with 923 wounds between May 2019 and March 2020. The observation period ended in March 2021. Median age was 10 years (IQR 7\u201315), 63.0% of patients were male. Almost all (99.5%, 870\/874) wounds closed within the observation period, 5.3% (49\/923) were lost to follow-up. Wounds primarily treated in C, HC and DH closed within a median time of 10, 16 and 170 days, respectively. Median time to acute wound and chronic wound closure was 13 and 72 days, respectively. Wounds treated in C, HC and DH presented with secondary bacterial infections in 10.3% (36\/350), 31.0% (133\/429) and 100% (5\/5) of cases, respectively. Recapturing was required in 68.3% (630\/923) of wounds with participants reporting wound closure as the main reason for not attending follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>We describe a wound management model based on national and WHO recommendations focusing on early identification and treatment in the community with potential for broad implementation in low-income countries.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>Registration at ClinicalTrials.gov (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03957447\" xlink:type=\"simple\">NCT03957447<\/jats:ext-link>).<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010730","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T17:29:01Z","timestamp":1665682141000},"page":"e0010730","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Community-based wound management in a rural setting of C\u00f4te d\u2019Ivoire"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-8241","authenticated-orcid":true,"given":"Simone","family":"Toppino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier Yao","family":"Koffi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bognan Valentin","family":"Kone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond T. A. S.","family":"N\u2019Krumah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isma\u00ebl Dognimin","family":"Coulibaly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Tobian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"Pluschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marija","family":"Stojkovic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bassirou","family":"Bonfoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Junghanss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"pntd.0010730.ref001","unstructured":"WHO. Recognizing Neglected Tropical Diseases Through Changes on the Skin. 2018. http:\/\/www.who.int\/neglected_diseases\/en"},{"key":"pntd.0010730.ref002","first-page":"1","article-title":"\u201cIt is me who endures but my family that suffers\u201d: Social isolation as a consequence of the household cost burden of buruli ulcer free of charge hospital treatment","volume":"2","author":"KP Grietens","year":"2008","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010730.ref003","unstructured":"World Health Organization. Mental health of people with neglected tropical diseases: towards a person-centred approach. 2020. https:\/\/www.who.int\/health-topics\/mental-health#tab=tab_2"},{"key":"pntd.0010730.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40249-021-00891-8","article-title":"Mental health and quality of life burden in Buruli ulcer disease patients in Ghana","volume":"10","author":"YA Amoako","year":"2021","journal-title":"Infect Dis Poverty"},{"key":"pntd.0010730.ref005","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s00268-015-3369-x","article-title":"Surgical management of chronic wounds in a Buruli ulcer endemic area in Central Africa","volume":"40","author":"ML Guifo","year":"2016","journal-title":"World J Surg"},{"key":"pntd.0010730.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0005331","article-title":"Assessing and managing wounds of Buruli ulcer patients at the primary and secondary health care levels in Ghana","volume":"11","author":"NO Addison","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010730.ref007","unstructured":"WHO. Wound and lymphoedema management. WHO\/HTM\/NTD\/GBUI\/20101 I. 2010."},{"key":"pntd.0010730.ref008","doi-asserted-by":"crossref","first-page":"e0005136","DOI":"10.1371\/journal.pntd.0005136","article-title":"Integrated Control and Management of Neglected Tropical Skin Diseases","volume":"11","author":"O Mitj\u00e0","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010730.ref009","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0006291","article-title":"Implementation of a decentralized community-based treatment program to improve the management of Buruli ulcer in the Ouinhi district of Benin, West Africa","volume":"12","author":"AS Amoussouhoui","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010730.ref010","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.actatropica.2016.12.023","article-title":"Characteristics and epidemiological profile of Buruli ulcer in the district of Tiassal\u00e9, south C\u00f4te d\u2019Ivoire","volume":"175","author":"RTAS N\u2019krumah","year":"2017","journal-title":"Acta Trop"},{"key":"pntd.0010730.ref011","doi-asserted-by":"crossref","DOI":"10.3402\/gha.v8.27271","article-title":"Causes of death in the Taabo health and demographic surveillance system, C\u01d2te d\u2019Ivoire, from 2009 to 2011","volume":"8","author":"S Kon\u00e9","year":"2015","journal-title":"Glob Health Action"},{"key":"pntd.0010730.ref012","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/ije\/dyu221","article-title":"Health & demographic surveillance system profile: The taabo health and demographic surveillance system, c\u00f4te d\u2019ivoire","volume":"44","author":"S Kon\u00e9","year":"2015","journal-title":"Int J Epidemiol"},{"key":"pntd.0010730.ref013","doi-asserted-by":"crossref","unstructured":"Toppino S, N\u2019krumah RTAS, Kone BV, Koffi DY, Coulibaly ID, Tobian F, et al. Skin wounds in a rural setting of C\u00f4te d\u2019Ivoire: population-based assessment of the burden and clinical epidemiology. Linked submission to PLoS Neglected Tropical Diseases. https:\/\/doi.org\/10.1371\/journal.pntd.0010608","DOI":"10.1371\/journal.pntd.0010608"},{"key":"pntd.0010730.ref014","first-page":"28","article-title":"Improving accuracy of wound measurement in clinical practice","volume":"49","author":"M. Flanagan","year":"2003","journal-title":"Ostomy Wound Manage"},{"key":"pntd.0010730.ref015","volume-title":"Cochrane Database of Systematic Reviews","author":"R Fernandez","year":"2008"},{"key":"pntd.0010730.ref016","first-page":"40","article-title":"A Cross-sectional Validation Study of Using NERDS and STONEES to Assess Bacterial Burden","volume":"55","author":"KY Woo","year":"2009","journal-title":"Ostomy Wound Manag"},{"key":"pntd.0010730.ref017","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"key":"pntd.0010730.ref018","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"pntd.0010730.ref019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0004385","article-title":"Differential Diagnosis of Skin Ulcers in a Mycobacterium ulcerans Endemic Area: Data from a Prospective Study in Cameroon","volume":"10","author":"L Toutous Trellu","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010730.ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0006489","article-title":"Skin disease prevalence study in schoolchildren in rural C\u00f4te d\u2019Ivoire: Implications for integration of neglected skin diseases (skin NTDs)","volume":"12","author":"RR Yotsu","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010730.ref021","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1111\/j.1365-4632.2012.05822.x","article-title":"Skin diseases among school children in Ghana, Gabon, and Rwanda","volume":"52","author":"A Hogewoning","year":"2013","journal-title":"Int J Dermatol"},{"key":"pntd.0010730.ref022","article-title":"Epidemiology and disease burden of Buruli ulcer: a review","volume":"59","author":"G Pluschke","year":"2015","journal-title":"Res Rep Trop Med"},{"key":"pntd.0010730.ref023","doi-asserted-by":"crossref","first-page":"120","DOI":"10.3390\/tropicalmed3040120","article-title":"Integrated Management of Skin NTDs\u2014Lessons Learned from Existing Practice and Field Research","volume":"3","author":"R. Yotsu","year":"2018","journal-title":"Trop Med Infect Dis"},{"key":"pntd.0010730.ref024","doi-asserted-by":"crossref","first-page":"e0005557","DOI":"10.1371\/journal.pntd.0005557","article-title":"Yaws resurgence in Bankim, Cameroon: The relative effectiveness of different means of detection in rural communities","volume":"11","author":"AU Boock","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0010730.ref025","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.trstmh.2004.03.008","article-title":"Definition of an algorithm for the management of common skin diseases at primary health care level in sub-Saharan Africa","volume":"99","author":"A Mah\u00e9","year":"2005","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0010730.ref026","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0006584","article-title":"Integrated approach in the control and management of skin neglected tropical diseases in Lalo, Benin","volume":"12","author":"YT Barogui","year":"2018","journal-title":"PLoS Negl Trop Dis"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010730","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T17:29:37Z","timestamp":1665682177000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010730"}},"subtitle":[],"editor":[{"given":"Mohamed Gomaa","family":"Kamel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":26,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0010730","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,13]]}}}