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

M Ombay,L Jilek-Aall,B Mathias,A Winkler,M Mayer,E Schmutzhard

doi:10.4314/ajtcam.v7i2.50877

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 sub- Saharan 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.

Highlights

Epilepsy is the most common neurological disorder throughout sub-Saharan Africa
During interviews with people affected (PWE and their relatives; n=121) and those not affected by epilepsy (n=46; see table 1) together with traditional healers (n=4) various traditional healing methods (THM) could be ascertained, i.e. traditional herbal medicine, spiritual healing, scarification and spitting
THM are practised throughout the African continent and widely accepted as a helpful therapy for virtually all ailments, including epilepsy

Summary

Introduction

Epilepsy is the most common neurological disorder throughout sub-Saharan Africa. A recent study from northern Tanzania indicates that epileptic seizures account for 3% of all hospital admissions and 27% of neurological diagnoses (Mosser et al, 2007). Prevalence data on epilepsy has been collected throughout Africa with varying results depending on study population and applied methodology ranging from 5.2-74.4/1000 inhabitants with a median prevalence of 15/1000 (Forsgren, 2008; Preux and Druet-Cabanac, 2005). This compares to resource rich countries where the prevalence of epilepsy is estimated to be about 4-8/1000 inhabitants (Forsgren et al, 2005). A recent study from the southern part of Tanzania has shown that over 95% of PWE were not on treatment (Dent et al, 2005). Insufficient availability of drugs and scarcity of qualified medical personnel may be responsible for most of the big treatment gap (Scott et al, 2001)

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