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

Am J Trop Med Hyg. 2013 Jul;89(1 Suppl):21-28. doi: 10.4269/ajtmh.12-0753. Epub 2013 Apr 29.

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.

MeSH terms

  • Adult
  • Caregivers / psychology*
  • Child, Preschool
  • Diarrhea, Infantile / epidemiology*
  • Diarrhea, Infantile / physiopathology
  • Diarrhea, Infantile / psychology*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Surveys
  • Hospitals, State
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mali / epidemiology
  • Medicine, Traditional
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Prevalence
  • Referral and Consultation
  • Severity of Illness Index