The epidemiology of ‘bewitchment’ as a lay-reported cause of death in rural South Africa
Identifieur interne : 001281 ( Ncbi/Curation ); précédent : 001280; suivant : 001282The epidemiology of ‘bewitchment’ as a lay-reported cause of death in rural South Africa
Auteurs : Edward Fottrell [Suède, Royaume-Uni] ; Stephen Tollman [Afrique du Sud] ; Peter Byass [Suède] ; Frederick Golooba-Mutebi [Ouganda] ; Kathleen Kahn [Afrique du Sud]Source :
- Journal of Epidemiology and Community Health [ 0143-005X ] ; 2011.
Abstract
Cases of premature death in Africa may be attributed to witchcraft. In such settings, medical registration of causes of death is rare. To fill this gap, verbal autopsy (VA) methods record signs and symptoms of the deceased before death as well as lay opinion regarding the cause of death; this information is then interpreted to derive a medical cause of death. In the Agincourt Health and Demographic Surveillance Site, South Africa, around 6% of deaths are believed to be due to ‘bewitchment’ by VA respondents.
Using 6874 deaths from the Agincourt Health and Socio-Demographic Surveillance System, the epidemiology of deaths reported as bewitchment was explored, and using medical causes of death derived from VA, the association between perceptions of witchcraft and biomedical causes of death was investigated.
The odds of having one's death reported as being due to bewitchment is significantly higher in children and reproductive-aged women (but not in men) than in older adults. Similarly, sudden deaths or those following an acute illness, deaths occurring before 2001 and those where traditional healthcare was sought are more likely to be reported as being due to bewitchment. Compared with all other deaths, deaths due to external causes are significantly less likely to be attributed to bewitchment, while maternal deaths are significantly more likely to be.
Understanding how societies interpret the essential factors that affect their health and how health seeking is influenced by local notions and perceived aetiologies of illness and death could better inform sustainable interventions and health promotion efforts.
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DOI: 10.1136/jech.2010.124305
PubMed: 21515546
PubMed Central: 3402739
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xml:lang="en" level="a" type="main">The epidemiology of ‘bewitchment’ as a lay-reported cause of death in rural South Africa</title><author><name sortKey="Fottrell, Edward" sort="Fottrell, Edward" uniqKey="Fottrell E" first="Edward" last="Fottrell">Edward Fottrell</name><affiliation wicri:level="1"><nlm:aff id="aff1">Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå</wicri:regionArea><wicri:noRegion>Umeå</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="aff2">Centre for International Health and Development, Institute of Child Health, University College London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for International Health and Development, Institute of Child Health, University College London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Tollman, Stephen" sort="Tollman, Stephen" uniqKey="Tollman S" first="Stephen" last="Tollman">Stephen Tollman</name><affiliation wicri:level="1"><nlm:aff id="aff3">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg</wicri:regionArea><wicri:noRegion>Johannesburg</wicri:noRegion></affiliation></author><author><name sortKey="Byass, Peter" sort="Byass, Peter" uniqKey="Byass P" first="Peter" last="Byass">Peter Byass</name><affiliation wicri:level="1"><nlm:aff id="aff1">Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden</nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea>Umeå Centre for Global Health Research, Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå</wicri:regionArea><wicri:noRegion>Umeå</wicri:noRegion></affiliation></author><author><name sortKey="Golooba Mutebi, Frederick" sort="Golooba Mutebi, Frederick" uniqKey="Golooba Mutebi F" first="Frederick" last="Golooba-Mutebi">Frederick Golooba-Mutebi</name><affiliation wicri:level="1"><nlm:aff id="aff4">Makerere Institute of Social Research, Makerere University, Kampala, Uganda</nlm:aff><country xml:lang="fr">Ouganda</country><wicri:regionArea>Makerere Institute of Social Research, Makerere University, Kampala</wicri:regionArea><wicri:noRegion>Kampala</wicri:noRegion></affiliation></author><author><name sortKey="Kahn, Kathleen" sort="Kahn, Kathleen" uniqKey="Kahn K" first="Kathleen" last="Kahn">Kathleen Kahn</name><affiliation wicri:level="1"><nlm:aff id="aff3">MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa</nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg</wicri:regionArea><wicri:noRegion>Johannesburg</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Epidemiology and Community Health</title><idno type="ISSN">0143-005X</idno><idno type="eISSN">1470-2738</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Cases of premature death in Africa may be attributed to witchcraft. In such settings, medical registration of causes of death is rare. To fill this gap, verbal autopsy (VA) methods record signs and symptoms of the deceased before death as well as lay opinion regarding the cause of death; this information is then interpreted to derive a medical cause of death. In the Agincourt Health and Demographic Surveillance Site, South Africa, around 6% of deaths are believed to be due to ‘bewitchment’ by VA respondents.</p></sec><sec><title>Methods</title><p>Using 6874 deaths from the Agincourt Health and Socio-Demographic Surveillance System, the epidemiology of deaths reported as bewitchment was explored, and using medical causes of death derived from VA, the association between perceptions of witchcraft and biomedical causes of death was investigated.</p></sec><sec><title>Results</title><p>The odds of having one's death reported as being due to bewitchment is significantly higher in children and reproductive-aged women (but not in men) than in older adults. Similarly, sudden deaths or those following an acute illness, deaths occurring before 2001 and those where traditional healthcare was sought are more likely to be reported as being due to bewitchment. Compared with all other deaths, deaths due to external causes are significantly less likely to be attributed to bewitchment, while maternal deaths are significantly more likely to be.</p></sec><sec><title>Conclusions</title><p>Understanding how societies interpret the essential factors that affect their health and how health seeking is influenced by local notions and perceived aetiologies of illness and death could better inform sustainable interventions and health promotion efforts.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Evans Pritchard, Ee" uniqKey="Evans Pritchard E">EE Evans-Pritchard</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ashforth, A" uniqKey="Ashforth A">A Ashforth</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Izugbara, Co" uniqKey="Izugbara C">CO 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