Traditional healers, treatment delay, performance status and death from TB in rural South Africa
International Journal of Tuberculosis and Lung Disease
Department of Respiratory Medicine, King's College Hospital, London, United Kingdom; Jane Furse Memorial Hospital, Jane Furse, Limpopo Province, South Africa; Division of Infectious Diseases, St. Louis University Hospital, St. Louis, MI, United States; Department of Respiratory Medicine, King's College Hospital, Bessemer Rd, London SE5 9PJ, United Kingdom
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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. © 2006 The Union.
adolescent; adult; aged; article; female; health service; health status; human; major clinical study; male; priority journal; therapy delay; traditional medicine; tuberculosis; Humans; Medicine, Traditional; Rural Health; South Africa; Time Factors; Tuberculosis, Pulmonary