Community awareness, symptom recognition, and perceived causes of skin neglected tropical diseases in selected regions of Ghana

Background

Leprosy and other skin neglected tropical diseases, including Buruli ulcer and yaws, remain significant public health challenges in Ghana. Despite control efforts, these conditions continue to cause disability, stigma, and social exclusion, particularly in rural and underserved communities. Misconceptions rooted in cultural and spiritual beliefs further delay care-seeking and reinforce discrimination.

Objective

This study assessed community awareness, symptom recognition, and perceived causes of leprosy and other skin NTDs across four regions of Ghana, and examined how these varied by socio-demographic characteristics, to inform culturally appropriate interventions for early detection and stigma reduction.

Methods

An analytical cross-sectional survey was conducted among 1,067 adults in Greater Accra, Eastern, Bono, and Savannah Regions of Ghana. Data were collected using structured questionnaires administered via Kobo Collect. Descriptive statistics summarized socio-demographic characteristics and outcome variables, including awareness, symptom recognition, and perceived causes of skin neglected tropical diseases. Associations between these outcomes and socio-demographic factors were assessed using chi-square tests, with statistical significance set at p  ≤ 0.05.

Results

Overall awareness of skin NTDs was high (75.6%) and was significantly associated with respondents’ educational level ( χ 2  = 38.081, p  < 0.001) and region of residence ( χ 2  = 42.661, p  < 0.001). Respondents with higher educational attainment and those from the Bono Region showed higher levels of awareness, whereas awareness was lowest among respondents from the Eastern Region. Symptom recognition was also assessed, with wounds (32.6%) and skin lesions (21.7%) being the most commonly identified manifestations. Perceived causes reflected a combination of biomedical and sociocultural explanations; bacterial infection and genetic factors were the most frequently reported causes, although supernatural beliefs remained prevalent, particularly among respondents with lower educational attainment.

Conclusion

This study shows that community awareness, symptom recognition, and perceived causes of skin NTDs in Ghana differ across socio-demographic and regional contexts. Interventions should prioritize communities and population groups with lower awareness, strengthen education on early skin NTD symptoms and their biomedical causes, and engage local leaders to address misconceptions and stigma, thereby improving early detection and timely healthcare-seeking.