Pulmonary tuberculosis vs. Tindzhaka and Mafularha: A mixed methods inquiry of traditional healers’ perceptions of tuberculosis in rural South Africa
Date
2023-04-21
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Although awareness of tuberculosis (TB) is high in South Africa, delays in TB testing or
treatment persist. Even those with symptoms of TB often delay testing, with one study in
Mpumalanga revealing a median allopathic care-seeking delay of four weeks. We sought to
understand how traditional healers perceived TB symptoms among their patients, if they
treated the disease, and what (if any) illnesses they defined as being traditional may have
overlapping presentation with TB in South Africa. Nineteen traditional healers completed an
in-depth interview (IDIs); 133 completed a quantitative survey about their treatment practices. IDIs focused on lung diseases treated, disease causation, treatment, and prognosis.
Survey questions investigated diagnosis of lung ailments, including those treated by the allopathic health system and those by traditional healers. Traditional healers reported that they
could differentiate between TB and traditional illnesses, like Tindzhaka and Mafularha, that
presented with similar symptoms. Few (7.5%) believed they could treat TB, but the majority
(72.9%) believed they could successfully treat Tindzhaka and Mafularha. Tindzhaka and
Mafularha are interconnected illnesses that are reportedly caused by breaking social rules
around death, sex and using the belongings of someone who recently passed away. Both, if
not treated, are considered fatal. While we have no definitive data, traditional healers may
be contributing to delays in the diagnosis and treatment for people with active TB by incorrectly diagnosing TB as Tindzhaka or Mafularha. Overcoming issues of trust and compensation, while respecting different forms of knowledge, are some of the challenges we face in
successfully engaging with healers.