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

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.

Keywords: Africa; Epilepsy; Global health; Healthcare delivery; Traditional medicine.

Figure 1:

A) and B) Talisman (French), gris-gris (Malinké), or sebe (Susu) prescribed by traditional healers to PWE for protection against djina and other malevolent spirits. C) Herbs and extracts used by a traditional healer in Conakry. D) Application of suction cups to the skin by a traditional healer. Traditional healing practices.