Seeking Care for Pediatric Diarrheal Illness from Traditional Healers in Bamako, Mali
Identifieur interne : 002340 ( Main/Curation ); précédent : 002339; suivant : 002341Seeking Care for Pediatric Diarrheal Illness from Traditional Healers in Bamako, Mali
Auteurs : Tamer H. Farag ; Karen L. Kotloff ; Myron M. Levine ; Uma Onwuchekwa ; Anna Maria Van Eijk ; Sanogo Doh ; Samba O. SowSource :
- The American Journal of Tropical Medicine and Hygiene [ 0002-9637 ] ; 2013.
Abstract
Diarrhea is a leading cause of child mortality worldwide. Early recognition of symptoms and referral to medical treatment are essential. In 2007, we conducted a Healthcare Utilization and Attitudes Survey (HUAS) of 1,000 children randomly selected from a population census to define care-seeking patterns for diarrheal disease in Bamako, Mali, in preparation for the Global Enteric Multicenter Study (GEMS). We found that 57% of caretakers sought care for their child's diarrheal illness from traditional healers, and 27% of caretakers sought care from the government health center (GHC). Weighted logistic regression showed that seeking care from a traditional healer was associated with more severe reported diarrheal disease, like decreased urination (odds ratio [OR] = 3.35, 95% confidence interval [95% CI] = 1.19–9.41) and mucus or pus in stool (OR = 4.42, 95% CI = 1.35–14.51), along with other indicators of perceived susceptibility. A locally designed traditional healer referral system was, therefore, created that emphasized more severe disease. This system may serve as a model for health systems in West Africa.
Url:
DOI: 10.4269/ajtmh.12-0753
PubMed: 23629935
PubMed Central: 3748497
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Farag</name></author><author><name sortKey="Kotloff, Karen L" sort="Kotloff, Karen L" uniqKey="Kotloff K" first="Karen L." last="Kotloff">Karen L. Kotloff</name></author><author><name sortKey="Levine, Myron M" sort="Levine, Myron M" uniqKey="Levine M" first="Myron M." last="Levine">Myron M. Levine</name></author><author><name sortKey="Onwuchekwa, Uma" sort="Onwuchekwa, Uma" uniqKey="Onwuchekwa U" first="Uma" last="Onwuchekwa">Uma Onwuchekwa</name></author><author><name sortKey="Van Eijk, Anna Maria" sort="Van Eijk, Anna Maria" uniqKey="Van Eijk A" first="Anna Maria" last="Van Eijk">Anna Maria Van Eijk</name></author><author><name sortKey="Doh, Sanogo" sort="Doh, Sanogo" uniqKey="Doh S" first="Sanogo" last="Doh">Sanogo Doh</name></author><author><name sortKey="Sow, Samba O" sort="Sow, Samba O" uniqKey="Sow S" first="Samba O." last="Sow">Samba O. Sow</name></author></analytic><series><title level="j">The American Journal of Tropical Medicine and Hygiene</title><idno type="ISSN">0002-9637</idno><idno type="eISSN">1476-1645</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Diarrhea is a leading cause of child mortality worldwide. Early recognition of symptoms and referral to medical treatment are essential. In 2007, we conducted a Healthcare Utilization and Attitudes Survey (HUAS) of 1,000 children randomly selected from a population census to define care-seeking patterns for diarrheal disease in Bamako, Mali, in preparation for the Global Enteric Multicenter Study (GEMS). We found that 57% of caretakers sought care for their child's diarrheal illness from traditional healers, and 27% of caretakers sought care from the government health center (GHC). Weighted logistic regression showed that seeking care from a traditional healer was associated with more severe reported diarrheal disease, like decreased urination (odds ratio [OR] = 3.35, 95% confidence interval [95% CI] = 1.19–9.41) and mucus or pus in stool (OR = 4.42, 95% CI = 1.35–14.51), along with other indicators of perceived susceptibility. A locally designed traditional healer referral system was, therefore, created that emphasized more severe disease. 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