title: Seeking care for pediatric diarrheal illness from traditional healers in Bamako, Mali.
abstract: Diarrhea is a leading cause of child mortality worldwide. Early recognition of symptoms and referral to medical treatment are essential. In 2007, we conducted a Healthcare Utilization and Attitudes Survey (HUAS) of 1,000 children randomly selected from a population census to define care-seeking patterns for diarrheal disease in Bamako, Mali, in preparation for the Global Enteric Multicenter Study (GEMS). We found that 57% of caretakers sought care for their child's diarrheal illness from traditional healers, and 27% of caretakers sought care from the government health center (GHC). Weighted logistic regression showed that seeking care from a traditional healer was associated with more severe reported diarrheal disease, like decreased urination (odds ratio [OR] = 3.35, 95% confidence interval [95% CI] = 1.19-9.41) and mucus or pus in stool (OR = 4.42, 95% CI = 1.35-14.51), along with other indicators of perceived susceptibility. A locally designed traditional healer referral system was, therefore, created that emphasized more severe disease. This system may serve as a model for health systems in West Africa.
authors: Tamer H
authors: TH
authors: Farag
authors: Karen L
authors: KL
authors: Kotloff
authors: Myron M
authors: MM
authors: Levine
authors: Uma
authors: U
authors: Onwuchekwa
authors: Anna Maria
authors: AM
authors: Van Eijk
authors: Sanogo
authors: S
authors: Doh
authors: Samba O
authors: SO
authors: Sow
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D003968:Diarrhea, Infantile / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006783:Hospitals, State; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008302:Mali / Q000453:epidemiology; D008519:Medicine, Traditional; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D012017:Referral and Consultation; D012720:Severity of Illness Index
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