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[In process citation]
1Institut National d’Hygiene Publique, INHP Abidjan, Cote d’Ivoire. diabygn@yahoo.fr
Insights
Traditional healers in Abidjan possess knowledge of malaria symptoms and treatments, often using herbal remedies. They recognize severe malaria and refer patients to modern facilities, highlighting potential for collaboration to reduce child mortality.
Area of Science:
- Medical Anthropology
- Public Health
- Traditional Medicine
Background:
- Malaria is a major health burden in Africa, particularly affecting young children and pregnant women.
- Traditional medicine is widely accessed in Africa due to its availability and affordability.
- A gap exists between traditional healers' practices and modern medicine, impacting patient management.
Purpose of the Study:
- To assess traditional healers' knowledge, attitudes, and practices regarding malaria in Abidjan.
- To explore the potential for collaboration between traditional and modern medicine for optimal malaria case management.
Main Methods:
- A cross-sectional study involving 60 traditional healers in Abidjan using individual interviews.
- Data collected via questionnaires on socio-demographics, malaria knowledge, diagnostic practices, and therapies.
- Interviews conducted in local languages, with translator assistance if needed.
Main Results:
- Most healers were herbalists (66.7%) or naturopaths (25%), with few spiritualists (8.3%).
- Commonly cited malaria causes included mosquito bites (16.7%), food, sun, and fatigue.
- Healers recognized key malaria symptoms like fever (100%) and dark urine (86%), and classified malaria into three forms.
- Herbal medicine (95%) was the primary treatment, with fever reduction as a healing sign.
- 90% referred severe malaria cases to modern health facilities, and 68.3% practiced malaria prophylaxis.
Conclusions:
- Traditional healers' clinical malaria descriptions align with modern medicine, though etiological reasoning is culturally influenced.
- Management relies on medicinal plants, with referrals for treatment failures.
- Integrating traditional healers into malaria control efforts, especially for early detection and referral, can reduce severe malaria-related child mortality.
Abstract:
INTRODUCTION : An estimated 300 to 500 million clinical cases of malaria occur each year worldwide, 90% in Africa, mostly among young children. In Cote d'Ivoire, malaria is 46.03% of disease states and 62.44% of hospital admissions. In children under 5 years, it is 42.67% of the reasons for consultation and 59.68% of hospital admissions. In pregnant women, it represents 22.91% of disease states and 36.07% of hospital admissions. In Africa, traditional medicine is the first resort for the vast majority of people, because of its accessibility both geographically, economically and culturally. However, some modern practitioners show an attitude of distrust of traditional medicine and its players, calling them irrational. This work had set out to assess knowledge, attitudes and practices of traditional healers in the uncomplicated and complicated in the context of collaboration between traditional and modern medicine for the optimal management of critical cases. MATERIALS AND METHOD : The study focused on traditional healers practicing in the city of Abidjan. The study was conducted using individual interviews over a period of 30 days. The interviews were conducted in local languages, with the assistance, if necessary, translators. For data collection, we used a questionnaire containing four items: the socio-demographic characteristics of traditional healers, their knowledge on malaria, diagnostic practices and traditional therapies. RESULTS : Of the 60 healers and included in the study, only six were women (10%), a sex-ratio of a woman to 9 men. 66.7% of respondents traditional healers are herbalists and 25% of naturopaths.Only 8.3% were spiritualists. The etiology of malaria most commonly cited by the traditional healers were mosquito bites (16.7%), food (1.7%), solar (1.7%) and fatigue (1.7%) . 25% of traditional healers are associated with mosquitoes, sun and fatigue. Symptomatology most cited were fever (100%), dark urine (86%), the yellow or pale conjunctiva (80%), vomiting (71.7%), nausea (58.3%) and abdominal pain (48.3%). Traditional healers recognized three types of malaria: the white shape, form yellow / red and the black form. Traditional healers malarious patients surveyed were receiving both first (58.3%) than second-line (41.7%). 78.3% of them practiced an interview and physical examination of theirpatients before the diagnosis. In 13.3% of cases they were divinatory consultation. Medications used to treat malaria were herbal in 95% of cases. The main sign of healing was the lack of fever (58.3%). 90%of traditional healers interviewed referring cases of malaria black (severe malaria). This reference is made to modern health facilities (90.2%). 68.3% of respondents practiced traditional healers of malaria prophylaxis among pregnant women and children under 5 years.CONCLUSION : A description of clinical malaria by traditional practitioners in health is not very far from that of modern medicine. Nevertheless, the logics of our respondents are etiological more complex and linked to their cultural context. The management of cases is made from medicinal plants in treatment failure patients are usually referred to modern health facilities. The involvement of traditional healers in the detection and quick reference risk cases can contribute to reducing child mortality due to severe malaria.
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