[Apparent malformations in an African area: factors influencing consultation delay in pediatric surgery]
N Doumbouya1, Y Brouh, R Attié
1Service de chirurgie pédiatrique Donka, Conakry, BP 234, République de Guinée. doctdoumbouya@yahoo.fr
Insights
Poverty, ignorance, and religious beliefs in Guinea and Ivory Coast communities delay medical consultations for children with apparent malformations. Addressing these factors is crucial for improving care and acceptance of affected children.
Area of Science:
- Pediatric Surgery
- Medical Anthropology
- Public Health
Context:
- Investigated attitudes in Guinean and Ivorian communities regarding delayed consultations for children with apparent malformations.
- Prospective study conducted from 2000-2002 in major teaching hospitals in Conakry and Abidjan.
Purpose:
- To analyze socio-cultural and economic factors contributing to delayed medical consultations for children with congenital malformations in Guinea and Ivory Coast.
- To understand community perceptions and beliefs influencing healthcare-seeking behavior for pediatric surgical conditions.
Summary:
- A study of 102 children with apparent malformations revealed a mean age of 17 months at first consultation, with 76% presenting between 1-30 months.
- Orthopedic malformations were most common (44%), often eliciting negative community reactions. Socio-economic status (54% low income), specific ethnic beliefs (e.g., divine punishment, witchcraft), and religious views significantly delayed consultations.
- Key barriers identified include poverty, lack of education, and cultural beliefs influencing parental decisions.
Impact:
- Findings highlight the need for culturally sensitive interventions and education in developing countries to improve early detection and management of pediatric malformations.
- Understanding these socio-cultural determinants is essential for enhancing healthcare access and acceptance for children with congenital anomalies.
- Recommendations include developing targeted health education programs and exploring medical insurance systems to mitigate financial barriers.
Aim:
To analyze the attitudes of the Guinean and of the Ivory Coast communities leading to delayed consultation despite apparent malformations in children.
Patients And Methods:
From January 1, 2000 to December 31, 2002, we carried out a prospective investigation in the paediatric surgery units of the Donka teaching hospital (Conakry) and Cocody, Treichville and Yopougon (Abidjan) teaching hospital. One hundred and two children affected with apparent malformations were included. The studied variables were: age, sex, ethnos group, religion, socio-economic level and the cultural designs of the families.
Results:
Sex ratio male/female was 1,5 and the average age at first consultation was 17 months. Seventy-six per cent of the children carrying apparent malformations at birth were seen at an age ranging from 1 to 30 months. Orthopaedic malformations were prominent (44%) and led especially to negative reactions of the entourage of the patients. Some religious beliefs took a part of the delayed consultation and impaired relationships between the 2 parents. The low socio-economic level (54%) was determining in the delayed consultation. The birth of a child with malformation in the malinké, akan krou community could be understood like a parchment from a god or a witchcraft.
Conclusion:
The contributive factors of the delay to the consultation of the children carrying apparent malformations in the communities Guinean and of the Ivory Coast are poverty, ignorance and some religious beliefs. Education and well understanding of these reasons in developing country should improve the acceptance and taking care of these children as well as the development of medical insurance system.