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几内亚共和国的癫痫与传统治疗师:一项混合方法研究。

Epilepsy and traditional healers in the Republic of Guinea: A mixed methods study.

机构信息

Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

Department of Neurology, Ignace Deen Teaching Hospital, Conakry, Guinea.

出版信息

Epilepsy Behav. 2019 Mar;92:276-282. doi: 10.1016/j.yebeh.2019.01.017. Epub 2019 Feb 12.

Abstract

PURPOSE

The purpose of this study was to characterize the reasons, extent, and impact of traditional medicine use among people with epilepsy (PWE) in the Republic of Guinea.

METHODS

Guinea is a low-income country in sub-Saharan Africa (SSA) with limited healthcare resources. People with epilepsy and their caregivers were seen at a public referral hospital in Conakry, the capital city, where they completed semi-structured interviews with physicians regarding their beliefs about epilepsy, medical care, and engagement with traditional healers.

RESULTS

Of 132 participants (49% children, 44% female, 55% with a university-educated head of household), 79% had seen a traditional healer, and 71% saw a traditional healer before seeing a medical provider for their epilepsy. Participants were treated by a traditional healer for a mean of 39 months before seeing a medical provider. By contrast, 58% of participants reported taking antiepileptic drugs (AEDs) regularly; 46% reported having undergone a head computed tomography (CT) scan; 58% reported having had an electroencephalogram, and 4% reported having had a brain magnetic resonance imaging (MRI) scan.

CONCLUSIONS

Traditional healers in Guinea provide frontline care for PWE in Guinea with considerable delays in AED initiation, even among a cohort of PWE actively seeking medical care. Engaging with these healers is critical for both influencing community perceptions and appropriately managing epilepsy throughout the country.

摘要

目的

本研究旨在描述几内亚共和国癫痫患者(PWE)使用传统医学的原因、程度和影响。

方法

几内亚是撒哈拉以南非洲(SSA)的一个低收入国家,医疗资源有限。在首都科纳克里的一家公立转诊医院,对 PWE 及其照顾者进行了访谈,医生与他们进行了半结构化访谈,了解他们对癫痫、医疗保健的看法以及与传统治疗师的互动情况。

结果

在 132 名参与者中(49%为儿童,44%为女性,55%的家庭户主受过大学教育),79%的人曾看过传统治疗师,71%的人在看医疗提供者治疗癫痫之前先看过传统治疗师。参与者在看医疗提供者之前平均接受传统治疗师治疗 39 个月。相比之下,58%的参与者报告定期服用抗癫痫药物(AEDs);46%的参与者报告进行过头颅计算机断层扫描(CT);58%的参与者报告进行了脑电图检查,4%的参与者报告进行了脑部磁共振成像(MRI)检查。

结论

在几内亚,传统治疗师为 PWE 提供了一线治疗,尽管他们中的许多人正在积极寻求医疗护理,但在开始使用 AED 方面存在相当大的延迟。与这些治疗师接触对于影响社区的看法和在全国范围内适当管理癫痫都至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e1a/6433505/ba3e9d1fbc2b/nihms-1519114-f0001.jpg

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