Local perceptions of tuberculosis in a rural district in Malawi.

SETTING

Ntcheu district, Malawi.

OBJECTIVE

To determine 1) the number of patients treated by traditional healers, 2) the type of diseases managed by them, 3) the perceived causes of these disease, and 4) how both patients and healers looked at tuberculosis (TB).

DESIGN

In-depth interviews and structured questionnaires with traditional healers, and focus group discussions with TB patients and their guardians.

RESULTS

Traditional healers recognized four main causes of disease, related to why the patient is sick rather than what the patient is suffering from. Two hundred and seventy-six traditional healers saw approximately 4600 patients a week, managing a variety of diseases, mainly of a chronic nature. Twenty-four per cent of patients seen by traditional healers had a cough, including patients with TB. Traditional healers believe they can cure TB, and have therefore been briefed on the infectious form of TB (smear-positive cases). The possibility of including traditional healers in early diagnosis has been explored.

CONCLUSION

There is a need to address local beliefs in health education and possibly find ways of involving healers in supervision of treatment.