Attitudes towards african traditional medicine and christian spiritual healing regarding treatment of epilepsy in a rural community of northern Tanzania

Abstract

Most people with epilepsy (PWE) live in developing countries with limited access to health care facilities. In sub-Saharan Africa with approximately 12 million PWE, 90% do not receive adequate medical treatment. In this context, traditional medicine, being easily accessible, plays an important role. However, in subSaharan Africa, studies on the attitude of people (both affected and not affected by epilepsy) towards traditional medicine for treatment of epilepsy are scarce. In this study, 167 people (59 PWE, 62 relatives, 46 villagers) were interviewed at the hospital and in the community with a semi-structured validated questionnaire regarding the prevailing attitude towards traditional medicine for treatment of epilepsy in a rural area of northern Tanzania. Various traditional healing methods (THM) could be ascertained, i.e. traditional herbal medicine, spiritual healing, scarifications and spitting. 44.3% (n=74/167) of the interviewed people were convinced that epilepsy could be treated successfully with THM. Interestingly, 34.1% (n=57/167) thought that Christian prayers could cure the cause and/or treat symptoms of epilepsy. Significantly more PWE and their relatives were in favour of THM compared to villagers not knowing about epilepsy or not being immediately affected by epilepsy (χ 2 -test, p=0.004). Further factors influencing people's attitudes towards THM were gender, tribe, religion and urbanity of people's dwellings. Our study demonstrates that not only THM but also prayers in the Christian sense seem to play an important role in people's beliefs regarding successful treatment of epilepsy. Factors influencing this belief system have been identified and are discussed.

Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management

“…In the absence of CT the clinician may attempt to get serial T. solium cysticercosis antigen levels 89 The 'access gap' is caused by factors such as inconsistent access to health facilities with antiepileptic medication, lack of knowledge of affected people and their families, medical personnel and entire communities on the topic of epilepsy, traditional concepts as to the origin of epilepsy and resulting stigma towards people with epilepsy, among other factors. [96][97][98][99] This stigma was clearly demonstrated in a recent study from Zambia which showed that people with epilepsy are disadvantaged regarding social and economic matters compared to people with other chronic diseases without an attached stigma, such as asthma, diabetes mellitus, hypertension, and rheumatic heart disease. 100 The 'adherence gap' which describes the failure of compliance with antiepileptic medication often is due to lack of information and education of the patients and their families as well as lack of time and lack of knowledge on treatment of health personnel.…”

“…Adherence to antiepileptic medication not only is influenced by health service related factors but again by stigma towards people with epilepsy and by people's belief systems which may view epilepsy as caused by demoniac possession or punishment for sins, among others. [96][97][98][99] Those and other factors that may be responsible for the 'epilepsy treatment gap' have to be taken into consideration when dealing with people with epilepsy/epileptic seizures in subSaharan Africa, irrespective of the origin of the epileptic seizures.…”

Traditional Medicine Practices in Epilepsy: Sample of Canakkale

“…[9] Winkler ve ark. [10] çalışmasına göre Tanzanya'da epilepsi hastalarınca uygulanan geleneksel tedaviler %9.6 geleneksel bitki tedavisi, %7.2 geleneksel manevi tedavi, %3.6 emetik özelliği olan bitki ile hastayı kusturma, %1.8 hastalığı kovma/çıkarma ve %34.1 dua etmedir.…”

Epilepsy and neurocysticercosis in sub-Saharan Africa

“…The lack of awareness of local and international policy makers, poor infrastructure, long travel distances, the insufficient or only intermittent availability of antiepileptic medications, the lack of education among people with epilepsy, their families and the communities, the predominance of traditional belief systems and the scarcity of trained medical personnel may be responsible for this large treatment gap [39,40]. Another important but often neglected cause of this treatment gap is social stigma.…”