TREATMENT PRACTICES FOR DEGEDEGE, A LOCALLY RECOGNIZED FEBRILE ILLNESS, AND IMPLICATIONS FOR STRATEGIES TO DECREASE MORTALITY FROM SEVERE MALARIA IN BAGAMOYO DISTRICT, TANZANIA

Malaria remains one of the chief causes of mortality among young child ren in sub-Saharan Africa. Verbal autopsies for cases of childhood mor tality in Bagamoyo District, Tanzania demonstrated that degedege, a lo cally defined illness of children characterized by fever and convulsio ns, is frequently treated by traditional healers. To investigate this further, an ethnographic study was carried out in one village that inc luded in-depth interviews with 14 traditional healers and 3 focus grou ps with parents. Parents and traditional healers were unanimous in the ir conviction that degedege requires traditional treatments, at least initially, and that these treatments are effective. While traditional healers do refer cases that are not improving to the District Hospital , this frequently occurs late in the course of the illness, after one or more stages of traditional treatments. The prognosis will thus be p oor for those children who are suffering from severe malaria. Consider ation should be given to enlisting the support of traditional healers in efforts to improve treatment for severe malaria, including teaching them how to distinguish febrile convulsions from cases of severe mala ria.