Traditional healers' perception on scabies causation and management in Ghana

Jian M Tehrani; Ingmar A Vos; Robin Kisabacak; Marten K Topper; Jonathan Steinhorst; Richard Odame Phillips; Kabiru Mohammed Abass; Samuel Osei-Mireku; Charles Owusu Anokye; Joseph K Adu Poku; Ymkje Stienstra; Yaw Ampem Amoako

doi:10.1111/tmi.13989

Traditional healers' perception on scabies causation and management in Ghana

Trop Med Int Health. 2024 Apr 10. doi: 10.1111/tmi.13989. Online ahead of print.

Authors

Jian M Tehrani¹, Ingmar A Vos¹, Robin Kisabacak¹, Marten K Topper¹, Jonathan Steinhorst¹, Richard Odame Phillips^{2

3}, Kabiru Mohammed Abass⁴, Samuel Osei-Mireku^{4

5}, Charles Owusu Anokye⁴, Joseph K Adu Poku⁴, Ymkje Stienstra^{1

6}, Yaw Ampem Amoako^{1

2

3}

Affiliations

¹ Department of Internal Medicine/Infectious Diseases, University Medical Centre Groningen, Groningen, The Netherlands.
² Kumasi Centre for Collaborative Research, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
³ School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁴ Agogo Presbyterian Hospital, Agogo, Ghana.
⁵ The Trust Hospital, Accra, Ghana.
⁶ Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.

PMID: 38599337
DOI: 10.1111/tmi.13989

Abstract

Introduction: Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies.

Methods: A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated.

Results: Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals.

Conclusion: The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.

Keywords: Ghana; perceptions; scabies; traditional healers.

Abstract

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