Abstract
Background: Autism spectrum disorders (ASD) are stigmatizing in Africa and traditional medical practitioners occupy the first line of diagnosis and treatment due to the cultural perception of ASD, and the scarcity of conventional health services in Mali. We aimed to assess the knowledge, attitudes, and practices (KAP) concerning autism among traditional medical practitioners in Bamako, Mali. Methods: We conducted a 6-week cross-sectional survey following a 1-day autism awareness seminary on September 9th, 2017 in Bamako. A questionnaire was designed to assess the KAP regarding autism. To assess their practices, parents of autistic children were asked about their experiences with traditional medical practitioners. Results: Of the 37 study participants 67.60% were males and 56.8% had not heard about autism before the seminary. After the seminary, 73% claimed to understand the diagnosis criteria of autism, but only 16.2% could recall symptoms from all the three domains (reciprocal social interaction, verbal and nonverbal communication, and stereotyped behaviors/restricted interests) of a child development impaired by autism. Of traditional medical practitioners, 73% believed autism was caused by devils, God’s will, bad luck and divine punishment of maternal misbehavior; 65% were used to treating mental illness, and 78.4% felt traditional healing was the only treatment option in autism. Negative attitudes towards autistic children were present in 18.9%, suggesting a very strong cultural mindset on autism. Conclusion: Knowledge on autism was poor among traditional medical practitioners. A culturally tailored autism public engagement strategy is necessary to positively change the mindset of Malian traditional medical practitioners.
Highlights
Despite autism spectrum disorders (ASD) being ubiquitous in Africa (Bayou et al, 2008; Honikman et al, 2012; Longe, 1976; Sanua, 1984), of the psychiatric disorders, Autism spectrum disorders (ASD) are poorly understood, neglected and stigmatizing across the continent (Abdullah & Brown, 2011; Stuart, 2005)
Since Mali has a long tradition of the use of medicinal plants and incantations in treating mental illnesses, traditional medical practitioners (TMP) in Mali are on the first line of diagnosis and care for autistic families
The present study has focused on TMP as part of a general campaign for ASD public engagement in the general population, health professionals and school teachers
Summary
Despite autism spectrum disorders (ASD) being ubiquitous in Africa (Bayou et al, 2008; Honikman et al, 2012; Longe, 1976; Sanua, 1984), of the psychiatric disorders, ASD are poorly understood, neglected and stigmatizing across the continent (Abdullah & Brown, 2011; Stuart, 2005). The lack of awareness of the general public regarding the symptoms, diagnosis and care of individuals with ASD (Arif et al, 2013) is mainly due to cultural beliefs and the scarcity of health services available to autistic families in sub-Saharan Africa. Autism spectrum disorders (ASD) are stigmatizing in Africa and traditional medical practitioners occupy the first line of diagnosis and treatment due to the cultural perception of ASD, and the scarcity of conventional health services in Mali. We aimed to assess the knowledge, attitudes, and practices (KAP) concerning autism among traditional medical practitioners in Bamako, Mali. A questionnaire was designed to assess the KAP regarding autism To assess their practices, parents of autistic children were asked about their experiences with traditional medical practitioners. A culturally tailored autism public engagement strategy is necessary to positively change the mindset of Malian traditional medical practitioners
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