Background: Survivors of past and present Ebola virus Disease (EVD) outbreaks in Africa are known to experiencing several forms of physical and psychological complications post-EVD discharge. The practice of medical pluralism and traditional, complementary and alternative medicine (TCAM) use is prevalent in Africa in addressing the health needs of the general and sub-health populations. However, the role of TCAM within the broader landscape of health seeking behaviours for EVD survivors is currently lacking in the contemporal EVD literature in Africa and Sierra Leone in particular.Purpose: To determine the pattern of healthcare seeking behaviour and TCAM use among EVD survivors .
Methods: We conducted self-administered and interview-administered nationwide study of adult EVD survivors in Sierra Leone. The study documents the different modes of healthcare-seeking behaviour, pattern and reasons for TCAM use.
Results: Of the 358 EVD survivors that completed the study, 223, (62.3%) were females, n=171(47.8%) were married/cohabitating. Arthralgia (89.1%), headache (76.0%), ocular symptoms (57.5%), fatigue (50.6) and back pain (50.0%) were the common Post-Ebola complications among EVD survivors. 308(86.0%) visited a doctor/nurse at hospital/EVD survivors clinic, 141(39.4%) visited a private pharmacy and 255(71.2%) self-medicated with conventional medicines. Meanwhile, 107(29.9%) self-used TCAM, 62(17.3%) and 41(11.5%) concurrently used and sought the service of a TCAM practitioner (mainly traditional medicine healer) respectively. Analgesics (85.2%) followed by antimicrobials (42.3%) were the commonest conventional medicine used by EVD survivors. Biological-based therapy (herbal medicine being the most) and mind and body therapies (prayer/spirituality, massage) were the commonest forms of TCAM modalities used. Key reasons cited for using TCAM include high cost of conventional medicine, conventional medicine not being effective to manage their post-ebola complications, TCAM being congruent with their beliefs and faith, health promotion and perception of TCAM being natural.
Conclusion: EVD survivors are utilizing traditional health care approaches alone or combination with conventional medicine to manage their post-Ebola sequalae. Healthcare providers interacting with this group of patients should be aware of this fact and promote an open dialogue that maximize benefit and reduce risk associated with TCAM among EVD survivors.