Impact of Community Health Volunteers in the Management of Buruli Ulcer in Imo State, South-Eastern Nigeria

Background and Objective: Buruli ulcer (BU), caused by Mycobacterium ulcerans, remains a neglected tropical disease with devastating consequences in rural West Africa. Early detection and prompt treatment are critical for reducing morbidity, yet access to health facilities is often constrained. Community Health Volunteers (CHVs) have been deployed as a frontline strategy to enhance early case detection and referral, but evidence on their effectiveness in Nigeria remains limited. Materials and Methods: A retrospective review of 600 laboratory-confirmed BU cases reported between January 2018-December 2024 in Imo State was conducted. Data on mode of case detection (CHVs vs. self-referral) were extracted from state health records and analyzed using descriptive statistics. Qualitative insights were triangulated from interviews with CHVs and health officials to contextualize findings. Results: Of the 600 cases, 450 (75.0%) were detected through Community Health Volunteers, while 150 (25.0%) were self-referred. CHVs significantly enhanced early detection and timely referral, leading to higher treatment initiation rates. Qualitative data revealed that Community Health Volunteers facilitated trust-building, community awareness, and reduced delays in care-seeking, though challenges such as limited incentives, training gaps, and cultural beliefs persisted. Conclusion: Community Health Volunteers play a pivotal role in the detection and management of Buruli ulcer in Imo State, Nigeria. Their involvement not only strengthens surveillance and referral pathways but also bridges sociocultural barriers to care. Scaling up Community Health Volunteers programs with improved training, logistical support, and integration into national Neglected Tropical Diseases frameworks could accelerate BU control and align with global elimination targets.