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Seeking care for pediatric diarrheal illness from traditional healers in Bamako, Mali

Tamer H Farag, Karen L Kotloff, Myron M Levine

    The American Journal of Tropical Medicine and Hygiene
    |May 1, 2013
    PubMed

    Insights

    Many caregivers in Mali seek traditional healers for childhood diarrhea, even with severe symptoms. A referral system was developed to improve care-seeking for severe pediatric diarrhea in West Africa.

    Area of Science:

    • Global Health
    • Pediatric Infectious Diseases
    • Health Services Research

    Background:

    • Diarrheal diseases represent a significant cause of mortality in children globally.
    • Prompt symptom recognition and medical referral are critical for effective treatment.
    • Understanding local care-seeking behaviors is essential for designing effective health interventions.

    Purpose of the Study:

    • To investigate care-seeking patterns for childhood diarrheal disease in Bamako, Mali.
    • To identify factors associated with seeking care from traditional healers versus government health centers.
    • To inform the development of a referral system for severe pediatric diarrhea.

    Main Methods:

    • A Healthcare Utilization and Attitudes Survey (HUAS) was conducted in 2007.
    • 1,000 children were randomly selected from a population census in Bamako, Mali.
    • Weighted logistic regression analysis was used to examine associations between disease severity indicators and care-seeking choices.

    Main Results:

    • 57% of caretakers sought care from traditional healers, while 27% utilized government health centers.
    • Seeking care from traditional healers was significantly associated with indicators of severe diarrhea, including decreased urination (OR=3.35) and mucus/pus in stool (OR=4.42).
    • Perceived susceptibility to severe illness also influenced care-seeking decisions.

    Conclusions:

    • Care-seeking for childhood diarrhea in Bamako is complex, with a substantial proportion of caretakers opting for traditional healers, particularly for severe cases.
    • A referral system emphasizing severe disease recognition was developed, potentially serving as a model for other West African health systems.
    • Integrating traditional healers into referral pathways could improve outcomes for severe pediatric diarrheal diseases.

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