Format

Send to

Choose Destination
BMC Res Notes. 2015 Aug 29;8:386. doi: 10.1186/s13104-015-1323-5.

Is the glass half full or half empty? A qualitative exploration on treatment practices and perceived barriers to biomedical care for patients with nodding syndrome in post-conflict northern Uganda.

Author information

1
Department of Medicine, Mulago Hospital and the School of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda. mwkaaad@yahoo.com.
2
Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda. elialilia@yahoo.co.uk.
3
Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda. cathya180@gmail.com.
4
Global Friends, Kampala, Uganda. frodwong@gmail.com.
5
Global Friends, Kampala, Uganda. olangowilly@gmail.com.
6
Soroti Regional Referral Hospital, Soroti, Uganda. jwetolu@yahoo.co.uk.
7
Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda. roriya2000@gmail.com.
8
School of Medicine, Gulu University, Gulu, Uganda. klagoro@gmail.com.
9
Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda. byamamutamba@yahoo.com.
10
Butabika National Mental Referral Hospital, Kampala, Uganda. byamamutamba@yahoo.com.
11
Department of Paediatrics and Child Health, Mulago Hospital and the School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. ridro1@gmail.com.
12
Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK. ridro1@gmail.com.
13
Ministry of Health Headquarters, Kampala, Uganda. bopato@gmail.com.
14
Ministry of Health Headquarters, Kampala, Uganda. janeaceng@gmail.com.
15
Ministry of Health Headquarters, Kampala, Uganda. lukwagoman@yahoo.com.
16
Department of Sociology and Anthropology, Makerere University, Kampala, Uganda. sheisim@yahoo.com.

Abstract

BACKGROUND:

Nodding syndrome has increasingly become an issue of public health concern internationally. The etiology of the disorder is still unknown and there are yet no curative treatments. We explored perceptions about treatment practices and barriers to health seeking for nodding syndrome in Pader and Kitgum districts in northern Uganda in order to provide data necessary for informing policy on treatment adherence and rehabilitations.

METHODS:

We used focus group discussions and individual interviews to gain deep insights into help-seeking and treatment practices for nodding syndrome. Purposive sampling was used to identify information-rich participants that included village health teams, community members not directly affected with nodding syndrome, district leaders, healthcare professionals, and caregivers of children affected with nodding syndrome. We used qualitative content analysis to analyze data and presented findings under distinct categories and themes.

RESULTS:

Caregivers and communities sought care from multiple sources including biomedical facilities, traditional healers, traditional rituals from shrines, and spiritual healing. Nodding syndrome affected children reportedly have showed no enduring improvement with traditional medicines, traditional rituals, and prayers. A substantial minority of participants reported minimal improvements in symptoms of convulsions with use of western medicines. Challenges involved in health seeking included; (1) health system factors e.g. long distances to facilities, frequent unavailability of medicines, few healthcare providers, and long waiting times; (2) contextual and societal challenges e.g. lack of money for transport and medical bills, overburdening nature of the illness that does not allow time for other activities, and practical difficulties involved in transporting the physically deformed and mentally retarded children to the health facilities.

CONCLUSIONS:

Help-seeking for nodding syndrome is pluralistic and include use of traditional and biomedical practices. Western medicines admittedly showed at least short term control on nodding syndrome symptoms, especially convulsions and led in a few cases to regain of functional abilities. However, multiple barriers hinder health seeking and interfere with adherence to biomedical treatments. Regarding cure, there are hitherto no treatments participants perceive cure nodding syndrome.

PMID:
26318338
PMCID:
PMC4552991
DOI:
10.1186/s13104-015-1323-5
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center