Social representation and practices related to dementia in Hai District of Tanzania

BMC Public Health

Richard Walker⁴  Chauka Mtuya³  Catherine Dotchin¹  Stella-Maria Paddick⁵  Amen Rongai²  Declare Mushi³ 

[1] Institute for Ageing and Health, Newcastle University, Newcastle upon, Tyne, UK;Partnership for Health and Development in Africa, Moshi, Tanzania;Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania;Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK;Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK

关键词: Life experience;    Beliefs;    Social-cultural;    Dementia;   

Others  :  1131891
DOI  :  10.1186/1471-2458-14-260

 received in 2013-08-01, accepted in 2014-03-10,  发布年份 2014

【 摘 要 】

Background

With the increasing number of people surviving into old age in Africa, dementia is becoming an important public health problem. Understanding the social dynamics of dementia in resource-poor settings is critical for developing effective interventions. We explored the socio-cultural beliefs surrounding dementia and the life experience of people with dementia (PWD) and their caregivers in the Hai District of Kilimanjaro, Tanzania.

Methods

Cross-sectional qualitative design. Forty one PWD were purposively sampled from the Hai District of Kilimanjaro. Twenty five paired interviews with PWD and with caregivers, and 16 with caregivers alone, were conducted. Interviews were tape recorded, transcribed verbatim and analyzed using content analysis approach.

Results

Forty one PWD (26 females), aged 70 years and older, were recruited but due to speech difficulties only 25 participated in the interviews. Married were 13, widow in 22 and widower 6. The majority, 33/41 were illiterate. PWD and carers perceived memory problems as a normal part of ageing. Dementia was commonly referred as "ugonjwa wa uzeeni" (disease of old people) or memory loss disease. The majority of PWD 13/12 and carers 7/16 did not know what dementia is or what causes it. Dementia was felt to be associated with stroke, high blood pressure, diabetes, old age, curse/witchcraft and life stress. Half of the participants had used modern care and alternative care such as herbs, prayers or traditional healers. Caregivers complained about the burden of caring for PWD and suggested that community organizations should be involved in addressing the problem.

Conclusions

Knowledge about dementia is low and the symptoms are accepted as a problem of old age. PWD and carers demonstrate pluralistic behaviour in seeking help from modern care, prayers and traditional healers. The disease adds significant burden to family members. Family and caregivers need more education on early recognition of symptoms and cost effective management of dementia at family level. Faith-based organizations could play an important role in dementia interventions. At a national level effective policy and improvement of the health care system to address the needs of PWD and their families are imperative.

【 授权许可】

   
2014 Mushi et al.; licensee BioMed Central Ltd.

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