[Kirikirimasien (epilepsy) in Mali: etiologic and nosologic dimensions]

Epilepsy is a chronic, disabling disease. Its incidence in Mali is 15.6 cases per 1000 people which is four to five times higher than in the West. Kirikirimasien is the name of a local bambaran disease entity similar to epilepsy with respect to both manifestations and course. A field study in a rural, bambaran area was performed to ascertain the nosologic nature of kirikirimasien and determine whether it was comparable with epilepsy in the west. Interviews with patients, family, friends, and healers were carried out and analyzed using qualitative investigative techniques, results showed that diagnosis was established on the basis of symptoms as well as underlying etiology. Nosologic information from the descriptions was correlated with contextual data in order to better understand the nature of the disease. To some extent close attention to pathologic signs associated with this disease such as dreaming and running away, revealed the important sociocultural dimension of kirikirimasien. This dimension is further supported by circumlocutions to avoid pronouncing the name of this disease considered as socially unacceptable. In summary, the sociocultural implications of kirikirimasien are evident in both criteria used for diagnosis and language used to describe it.