[Anthropologic research and understanding pediatric visceral leishmaniasis in Tunisia]

In order to determine the social and cultural factors which delay hospitalization of children suffering from visceral leishmaniasis (VL), a study was carried out in the rural area of Kairouan (Tunisia). Qualitative techniques were used to investigate beliefs and behaviours associated with the symptoms of VL. The study has demonstrated that the folk interpretation of the disease interferes largely with the choice of the therapy. Regarding VL, the subdivision of the disease into two groups of symptoms, fever and splenomegaly, incites parents to consult doctors in the presence of fever and use traditional healers when splenomegaly appears. This is responsible for long delays before the patients can have access to official health care. This investigation clearly demonstrated that a health education programme is needed in VL endemic areas in Tunisia in order to shorten delays between the appearance of symptoms and their diagnosis. For this objective to be achieved, it would also seem necessary to implement simple serodiagnostic techniques at the periphery level.