Article Category:
Research Article

Engagement with Traditional Healers for Early Detection of Plague in Uganda

Titus Apangu Uganda Virus Research Institute, Arua, Uganda;

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Gordian Candini Uganda Virus Research Institute, Arua, Uganda;

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Janet Abaru Uganda Virus Research Institute, Arua, Uganda;

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Bosco Candia Uganda Virus Research Institute, Arua, Uganda;

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Felix J. Okoth Uganda Virus Research Institute, Arua, Uganda;

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Linda A. Atiku Uganda Virus Research Institute, Arua, Uganda;

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Kevin S. Griffith Centers for Disease Control and Prevention, Fort Collins, Colorado;

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Mary H. Hayden National Center for Atmospheric Research, Boulder, Colorado

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Emily Zielinski-Gutiérrez Centers for Disease Control and Prevention, Fort Collins, Colorado;

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Amy M. Schwartz Centers for Disease Control and Prevention, Fort Collins, Colorado;

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David W. McCormick Centers for Disease Control and Prevention, Fort Collins, Colorado;

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Paul S. Mead Centers for Disease Control and Prevention, Fort Collins, Colorado;

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Kiersten J. Kugeler Centers for Disease Control and Prevention, Fort Collins, Colorado;

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DOI:
https://doi.org/10.4269/ajtmh.23-0101
Volume/Issue:
Volume 109: Issue 5
Page(s):
1129–1136
Restricted access
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ABSTRACT.

In rural Uganda, many people who are ill consult traditional healers prior to visiting the formal healthcare system. Traditional healers provide supportive care for common illnesses, but their care may delay diagnosis and management of illnesses that can increase morbidity and mortality, hinder early detection of epidemic-prone diseases, and increase occupational risk to traditional healers. We conducted open-ended, semi-structured interviews with a convenience sample of 11 traditional healers in the plague-endemic West Nile region of northwestern Uganda to assess their knowledge, practices, and attitudes regarding plague and the local healthcare system. Most were generally knowledgeable about plague transmission and its clinical presentation and expressed willingness to refer patients to the formal healthcare system. We initiated a public health outreach program to further improve engagement between traditional healers and local health centers to foster trust in the formal healthcare system and improve early identification and referral of patients with plaguelike symptoms, which can reflect numerous other infectious and noninfectious conditions. During 2010–2019, 65 traditional healers were involved in the outreach program; 52 traditional healers referred 788 patients to area health centers. The diagnosis was available for 775 patients; malaria (37%) and respiratory tract infections (23%) were the most common diagnoses. One patient had confirmed bubonic plague. Outreach to improve communication and trust between traditional healers and local healthcare settings may result in improved early case detection and intervention not only for plague but also for other serious conditions.

    • Supplemental Materials (PDF 185.76 KB)

Author Notes

Financial support: This work was supported by the U.S. Centers for Disease Control and Prevention, Division of Vector-Borne Diseases.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Authors’ addresses: Titus Apangu, Gordian Candini, Janet Abaru, Bosco Candia, Felix Jimmy Okoth, and Linda A. Atiku, Uganda Virus Research Institute, Arua, Uganda, E-mails: apangu26@gmail.com, gordiandini@gmail.com, abajanet54@gmail.com, candiabosco@gmail.com, felixsmrt@gmail.com, and l_atikupraise@yahoo.com. Kevin S. Griffith, U.S. President’s Malaria Initiative, USAID, Washington, DC, E-mail: kgriffith@usaid.gov. Mary H. Hayden, Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, CO, E-mail: mhayden@uccs.edu. Emily Zielinski-Gutiérrez, Centers for Disease Control and Prevention, Center for Global Health, Atlanta, GA, E-mail: ebz0@cdc.gov. Amy M. Schwartz, David W. McCormick, Paul S. Mead, and Kiersten J. Kugeler, Centers for Disease Control and Prevention, Fort Collins, CO, E-mails: amyschwartz@uiowa.edu, yup1@cdc.gov, pfm0@cdc.gov, and bio1@cdc.gov.

Address correspondence to Kiersten J. Kugeler, 3156 Rampart Rd., Fort Collins, CO 80521. E-mail: bio1@cdc.gov
Copyright:
© American Society of Tropical Medicine and Hygiene 2023
Received:
09 Feb 2023
|
Accepted:
15 Aug 2023
|
Published Online:
02 Oct 2023
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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