Diagnostic work-up of neurological syndromes in a rural African setting: knowledge, attitudes and practices of health care providers

Alain Mpanya, Marleen Boelaert, Sylvain Baloji, Junior Matangila, Symphorien Lubanza, Emmanuel Bottieau, François Chappuis, Pascal Lutumba, David Hendrickx

Research output: Contribution to journalA1: Web of Science-article

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Abstract

BACKGROUND: Neurological disorders of infectious origin are common in rural sub-Saharan Africa and usually have serious consequences. Unfortunately, these syndromes are often poorly documented for lack of diagnostic tools. Clinical management of these diseases is a major challenge in under-equipped rural health centers and hospitals. We documented health care provider knowledge, attitudes and practices related to this syndrome in two rural health zones in Bandundu Province, Democratic Republic of Congo.

METHODS: We used a qualitative research approach combining observation, in-depth interviews and focus group discussions. We observed 20 patient-provider contacts related to a neurological syndrome, conducted 12 individual interviews and 4 focus group discussions with care providers. All interviews were audiotaped and the transcripts were analyzed with the software ATLAS.ti.

RESULTS: Care providers in this region usually limit their diagnostic work-up to clinical examination primarily because of the financial hurdles in this entirely out-of-pocket payment system. The patients prefer to purchase drugs rather than diagnostic tests. Moreover the general lack of diagnostic tools and the representation of the clinician as a "diviner" do not enhance any use of laboratory or other diagnostic methods.

CONCLUSION: Innovation in diagnostic technology for neurological disorders is badly needed in Central-Africa, but its uptake in clinical practice will only be a success if tools are simple, affordable and embedded in a patient-centered approach.

Original languageEnglish
JournalPLoS ONE
Volume9
Issue number10
Pages (from-to)e110167
ISSN1932-6203
DOIs
Publication statusPublished - 2014

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