Abstract
BackgroundPastoralists rely on traditional healers (THs) for general health problems. However, some studies indicate that such practices result in delays in the diagnosis and treatment of tuberculosis (TB) cases. This study aims to assess the role of traditional healers in the detection and referral of active TB cases in a pastoralist community.MethodsWe identified 22 traditional healers from 7 villages of Kereyu pastoralist community in the Fentale district in Ethiopia in January 2015. We trained these THs in identifying presumptive TB symptoms and early referral to the nearby healthcare facilities. The training was held during a 1 week period that included a visit to their villages and follow-up. A 1 day meeting was held with the traditional healers, the district TB care and prevention coordinator and health extension workers from the selected sub-district to discuss the referral link between THs and the nearby healthcare facilities. Health providers working at the TB units in the selected healthcare facilities were oriented about the training given and planned involvement of THs in referring presumptive TB case. In addition, documentation of the presumptive TB cases was discussed.ResultsWe succeeded in tracing and interviewing 8 of the 22 THs. The rest were on seasonal migration. According to the THs report for the 1 year period, these 8 THs had referred 24 TB suspects to the healthcare facilities. Sputum smear microscopy confirmed 13 of the 24 suspects as having TB cases. Among those confirmed, 10 completed treatment and three were on treatment. Five presumptive TB cases were confirmed non TB cases through further evaluation at the healthcare facilities and six of the presumptive TB cases were lost to follow up by the THs. Whereas, four of the presumptive TB cases were lost to follow up to the healthcare facility.ConclusionsResults of the present study indicate that THs can contribute to the detection of undiagnosed active TB cases in a pastoralist community, provided they are given appropriate training and support.
Highlights
Pastoralists rely on traditional healers (THs) for general health problems
Pastoralists account for about 12% of the population in Ethiopia and they are the communities most affected by TB [2]
Study area This study was conducted in Fentale (Kereyu) Woreda (Woreda is equivalent to district) which is located in the east Shoa zone of Oromia, the southern part of the northern rift valley of Ethiopia
Summary
Some studies indicate that such practices result in delays in the diagnosis and treatment of tuberculosis (TB) cases. Ethiopia is Pastoralists account for about 12% of the population in Ethiopia and they are the communities most affected by TB [2] They mostly depend on traditional healers (THs) for their general health and illnesses, including TB. This holds true in most sub-Saharan countries where about 85% of the population visit THs regularly; in Ethiopia, up to 80% of the population use THs due to. The use of THs is a special challenge for TB prevention and care in the pastoralist area resulting in prolonged diagnostic and treatment delay of active TB cases [5, 6]. Studies showed the presence of strong link between visiting THs, diagnostic and treatment delay and death due to TB [7, 8]
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