Barker R D, Millard F J C, Malatsi J, Mkoana L, Ngoatwana T, Agarawal S, de Valliere S
Department of Respiratory Medicine, King's College Hospital, London, UK.
Int J Tuberc Lung Dis. 2006 Jun;10(6):670-5.
People in sub-Saharan Africa frequently consult traditional healers before reaching the government health services (GHS). This can lead to delays in starting effective anti-tuberculosis chemotherapy. To our knowledge, no studies have shown a direct relationship between visiting traditional healers, increased morbidity and death from TB.
All patients starting on anti-tuberculosis chemotherapy at a rural hospital in South Africa in 2003 were included in the study. TB nurses interviewed the patients and established how long they had had symptoms before treatment was started, whether they had visited traditional healers before coming to the hospital, their performance status and, later, whether they had died.
Of 133 patients, those who attended a traditional healer took longer to access anti-tuberculosis chemotherapy (median 90 days, range 0-210) than those who went directly to the GHS (median 21, range 0-120). Patients who visited a traditional healer had worse performance status (P < 0.001), and were more likely to die (24/77 [31%] vs. 4/33 [12%], P = 0.04).
Treatment delay due to visiting traditional healers can have dire consequences for patients with TB. Efforts are required to engage with health care practitioners outside the government sector to improve the prospects for patients with TB.
撒哈拉以南非洲地区的人们在前往政府医疗卫生服务机构（GHS）之前，经常会咨询传统治疗师。这可能导致开始有效的抗结核化疗出现延迟。据我们所知，尚无研究表明咨询传统治疗师与结核病发病率增加及死亡之间存在直接关系。
2003年在南非一家乡村医院开始接受抗结核化疗的所有患者均纳入本研究。结核病护理人员对患者进行了访谈，确定他们在开始治疗前出现症状的时间、来医院之前是否咨询过传统治疗师、他们的身体状况，以及后来是否死亡。
在133名患者中，咨询过传统治疗师的患者比直接前往GHS的患者获得抗结核化疗的时间更长（中位数90天，范围0 - 210天），而直接前往GHS的患者中位数为21天，范围0 - 120天。咨询过传统治疗师的患者身体状况更差（P < 0.001），且死亡可能性更高（24/77 [31%] 对比4/33 [12%]，P = 0.04）。
因咨询传统治疗师导致的治疗延迟可能给结核病患者带来严重后果。需要做出努力，与政府部门以外的医疗从业者合作，以改善结核病患者的预后。
