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Background: In a tropical setting such as Peru, skin ulcers are commonly caused by infectious diseases such as leishmaniasis. Early treatment results in improved patient outcomes. By exploring the health beliefs and behaviours of a patient it is possible to identify barriers to healthcare that prevent early treatment. These barriers could be addressed by public health schemes and also assessed quantitatively. To date there has been no research regarding this topic. Methods: A qualitative study was carried out in Yurimaguas, Peru. Nine semi-structured interviews were conducted with the help of a translator in February 2015. Patients were included if they had consulted a doctor in the past because of a skin ulcer. The transcripts were analysed using thematic content analysis and themes were developed. Results: Three main themes emerged from the data. 1) Many patients use their own treatments. These treatments can be harmful because of their inherent nature or because they delay consultation with a doctor. 2) Many of the participants relied on the advice of family and friends. This advice often encouraged the use of alternative remedies and thus delayed health-seeking behaviour. Participants stated that they themselves would give the same advice. 3) The main barriers to health care were identified in this population. These barriers included local strikes, lack of knowledge about skin ulcers, living in a rural location, informal consultations with family and friends and the diagnostic lag time for Leishmania infections. Conclusion: There are significant barriers, beliefs and behaviours identified that can be addressed by public health schemes. These schemes would decrease the time it takes for patient to consult a doctor and thus improve patient outcomes.

The Help Seeking Behaviours of Patients with Ulcerative Skin Lesions before Consultation in Yurimaguas, Peru