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Mixed methods inquiry into traditional healers' treatment of mental, neurological and substance abuse disorders in rural South Africa.

Abstract Traditional healers are acceptable and highly accessible health practitioners throughout sub-Saharan Africa. Patients in South Africa often seek concurrent traditional and allopathic treatment leading to medical pluralism.
PMID
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Authors

Mayor MeshTerms

Medicine, African Traditional

Keywords
Journal Title plos one
Publication Year Start




PMID- 29261705
OWN - NLM
STAT- MEDLINE
DCOM- 20180108
LR  - 20180108
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Mixed methods inquiry into traditional healers' treatment of mental, neurological
      and substance abuse disorders in rural South Africa.
PG  - e0188433
LID - 10.1371/journal.pone.0188433 [doi]
AB  - BACKGROUND: Traditional healers are acceptable and highly accessible health
      practitioners throughout sub-Saharan Africa. Patients in South Africa often seek 
      concurrent traditional and allopathic treatment leading to medical pluralism.
      METHODS & FINDINGS: We studied the cause of five traditional illnesses known
      locally as "Mavabyi ya nhloko" (sickness of the head), by conducting 27 in-depth 
      interviews and 133 surveys with a randomly selected sample of traditional healers
      living and working in rural, northeastern South Africa. These interviews were
      carried out to identify treatment practices of mental, neurological, and
      substance abuse (MNS) disorders. Participating healers were primarily female
      (77%), older in age (median: 58.0 years; interquartile range [IQR]: 50-67), had
      very little formal education (median: 3.7 years; IQR: 3.2-4.2), and had practiced
      traditional medicine for many years (median: 17 years; IQR: 9.5-30). Healers
      reported having the ability to successfully treat: seizure disorders (47%),
      patients who have lost touch with reality (47%), paralysis on one side of the
      body (59%), and substance abuse (21%). Female healers reported a lower odds of
      treating seizure disorders (Odds Ratio (OR):0.47), patients who had lost touch
      with reality (OR:0.26; p-value<0.05), paralysis of one side of the body
      (OR:0.36), and substance abuse (OR:0.36) versus males. Each additional year of
      education received was found to be associated with lower odds, ranging from
      0.13-0.27, of treating these symptoms. Each additional patient seen by healers in
      the past week was associated with roughly 1.10 higher odds of treating seizure
      disorders, patients who have lost touch with reality, paralysis of one side of
      the body, and substance abuse. Healers charged a median of 500 South African Rand
      (~US$35) to treat substance abuse, 1000 Rand (~US$70) for seizure disorders or
      paralysis of one side of the body, and 1500 Rand (~US$105) for patients who have 
      lost touch with reality. CONCLUSIONS: While not all healers elect to treat MNS
      disorders, many continue to do so, delaying allopathic health services to acutely
      ill patients.
FAU - Audet, Carolyn M
AU  - Audet CM
AD  - Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, United 
      States of America.
FAU - Ngobeni, Sizzy
AU  - Ngobeni S
AD  - MRC/Wits Agincourt Research Unit, School of Public Health, Faculty of Health
      Sciences, University of Witwatersrand, Johannesburg, South Africa.
FAU - Graves, Erin
AU  - Graves E
AD  - Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, United 
      States of America.
FAU - Wagner, Ryan G
AU  - Wagner RG
AD  - MRC/Wits Agincourt Research Unit, School of Public Health, Faculty of Health
      Sciences, University of Witwatersrand, Johannesburg, South Africa.
AD  - Umea Centre for Global Health Research, Umea University, Umea, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20171219
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Costs and Cost Analysis
MH  - Demography
MH  - Female
MH  - Humans
MH  - Male
MH  - *Medicine, African Traditional/economics
MH  - Mental Disorders/diagnosis/economics/*therapy
MH  - Middle Aged
MH  - Nervous System Diseases/diagnosis/economics/*therapy
MH  - Referral and Consultation
MH  - South Africa
MH  - Substance-Related Disorders/diagnosis/economics/*therapy
PMC - PMC5736181
EDAT- 2017/12/21 06:00
MHDA- 2018/01/09 06:00
CRDT- 2017/12/21 06:00
PHST- 2016/09/02 00:00 [received]
PHST- 2017/11/07 00:00 [accepted]
PHST- 2017/12/21 06:00 [entrez]
PHST- 2017/12/21 06:00 [pubmed]
PHST- 2018/01/09 06:00 [medline]
AID - 10.1371/journal.pone.0188433 [doi]
AID - PONE-D-16-35310 [pii]
PST - epublish
SO  - PLoS One. 2017 Dec 19;12(12):e0188433. doi: 10.1371/journal.pone.0188433.
      eCollection 2017.