Das Sanyam Sandip, Yadav Reena, H A Mohamed Ahmed Abeer, Arunga Simon, Leck Astrid, Macleod David, Roshan Abhishek, K Singh Sanjay, K Mishra Sailesh, J Hoffman Jeremy, J Burton Matthew, Mtuy Tara
Sagarmatha Choudhary Eye Hospital, Siraha, Lahan, 56502, Nepal.
International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
Wellcome Open Res. 2024 Nov 4;9:295. doi: 10.12688/wellcomeopenres.21241.2. eCollection 2024.
Microbial Keratitis (MK) is a leading cause of corneal blindness due to infection and its consequences, with a higher incidence in resource-limited nations. Hospital-based patient records from different parts of Nepal suggest patients often use traditional eye medicine to treat MK. Traditional healers (TH) within the community are often the first point of care for MK management. Little is known of their practice, perceptions, and knowledge around MK management. We aimed to understand the role of traditional healers in the management of MK in south-eastern Nepal.
A cross-sectional, mixed method, descriptive study was conducted in the Siraha district of Nepal. A total of 109 traditional healers consented to participate in a survey of knowledge, attitude, and practices. Some participants were also invited to participate in in-depth interviews and focus group discussions. Interviews and focus groups were conducted and recorded in the Maithili language by a native speaking interviewer and transcribed into English. Descriptive analysis was performed for the survey. Data saturation was considered the endpoint for qualitative data collection, and a thematic was analysis applied.
Traditional healers believe that infection of the eye can be caused by trauma, conjunctivitis, or evil spirits. They were unclear about differentiating MK from other eye conditions. They provided various types of treatment. Some were confident that they could treat severe ulcers that had not responded to medical therapy, while others thought treating larger diameter ulcers would be difficult. Although there were mixed responses in referring patients with MK, the majority of TH were willing to refer.
In a weak health system, traditional healers may help address barriers to healthcare access and reduce delays to definitive care, upon integration into the formal health system and referral pathway.
微生物性角膜炎（MK）是因感染及其后果导致角膜盲的主要原因，在资源有限的国家发病率较高。来自尼泊尔不同地区的医院患者记录表明，患者常使用传统眼药治疗MK。社区内的传统治疗师（TH）往往是MK治疗的首要护理点。对于他们在MK治疗方面的做法、认知和知识了解甚少。我们旨在了解尼泊尔东南部传统治疗师在MK治疗中的作用。
在尼泊尔的西拉哈区进行了一项横断面、混合方法的描述性研究。共有109名传统治疗师同意参与一项关于知识、态度和做法的调查。一些参与者还被邀请参加深入访谈和焦点小组讨论。访谈和焦点小组由一名母语为迈蒂利语的访谈者进行，用迈蒂利语进行记录，然后转录成英语。对调查进行描述性分析。将数据饱和视为定性数据收集的终点，并应用主题分析。
传统治疗师认为眼睛感染可能由外伤、结膜炎或邪灵引起。他们不清楚如何将MK与其他眼部疾病区分开来。他们提供了各种类型的治疗。一些人自信能够治疗对药物治疗无反应的严重溃疡，而另一些人则认为治疗直径较大的溃疡会很困难。尽管在转诊MK患者方面存在不同反应，但大多数传统治疗师愿意转诊。
在薄弱的卫生系统中，传统治疗师若能融入正规卫生系统和转诊途径，可能有助于消除医疗服务获取障碍并减少确定性治疗的延误。
