Traditional healers and pulmonary tuberculosis in Malawi

SETTING: Queen Elizabeth Central Hospital (QECH) and Blantyre district, Malawi. OBJECTIVE: To investigate the use that tuberculosis (TB) patients in Malawi make of traditional healers and traditional medicine. DESIGN: A questionnaire study was carried out on 89 smear-positive pulmonary TB patients admitted to QECH. Seven traditional healers in Blantyre were also interviewed about their knowledge, attitudes and practice of patients whom they considered to have TB. RESULTS: Of the 89 patients, 33 (37%) visited a traditional healer before seeking regular medical care. Patients spent a median length of 4 weeks with the traditional healer. During this time, 24 patients did not improve or deteriorated while on traditional treatment. No patient was referred to the medical services by the traditional healer. All traditional healers claimed to know about TB. Four said they would refer a patient to hospital if their treatment was not curative. In 1995, six traditional healers claimed to have cured 116 patients with TB. CONCLUSION: It is important to involve traditional healers in the educational activities of the National TB Control Programme. These healers need to be taught to not treat, but at the same time be encouraged to administer safe treatments for conditions which are more amenable to their practice.