Underestimation of hepatocellular carcinoma incidence resulting from a competition between modern and traditional medicine: the case of Gabon
| Autor: | Agnès Marchio, Pascal Pineau, JP Moussavou Kombila, Pamela Moussavou-Boundzanga, Augustin Mouinga-Ondeme, Patrice E Itoudi Bignoumba, Barthelemy Mabika |
|---|---|
| Přispěvatelé: | Université des Sciences et Techniques de Masuku (USTM), Université des Sciences de la Santé [Libreville, Gabon], Centre Hospitalier Universitaire de Libreville (CHUL), Organisation Nucléaire et Oncogenèse / Nuclear Organization and Oncogenesis, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Centre International de Recherches Médicales de Franceville (CIRMF), PMB was supported by a fellowship the Union for International Cancer Control (UICC) who granted PMB with an African Cancer fellowship for a training in Institut Pasteur., Université des Sciences et Techniques de Masuku [Franceville, Gabon] (USTM), MARCHIO, Agnes |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
High rate
medicine.medical_specialty Modern medicine primary liver cancer business.industry Public health Incidence (epidemiology) [SDV.CAN]Life Sciences [q-bio]/Cancer General Medicine medicine.disease Competition (economics) [SDV.CAN] Life Sciences [q-bio]/Cancer Hepatocellular carcinoma parasitic diseases medicine Etiology incidence epidemiology gabon Primary liver cancer business Demography |
| Zdroj: | Journal of Global Health Reports Journal of Global Health Reports, 2020, 4, pp.e2020063. ⟨10.29392/001c.13653⟩ |
| ISSN: | 2399-1623 |
| Popis: | International audience; Primary liver cancer, particularly hepatocellular carcinoma (HCC), remains a major killer in sub-Saharan Africa. In this dreadful landscape, West and Central Africas are more particularly affected. However, a small country located on the equator, Gabon, is apparently not concerned by this adverse situation. Despite worrying prevalences of many bona fide risk factors of HCC, including high rates of chronic infections with hepatitis viruses and very high alcohol consumption, Gabon presents theoretically an amazingly low incidence of HCC when compared to other countries of the region. Reports from many places in the world have emphasized the widespread underreporting of HCC cases presumably attributable to the difficulties of proper diagnosis or to a lack of local cancer registry. In Gabon, the remarkably vivid tradition of religious initiation called Bwiti includes some therapeutic rituals exerted by healers or Ngangas. Those treatments are particularly popular in case of severe diseases generally associated with a supernatural etiology. In the present paper, we hypothesize that, in Gabon, the remarkably low incidence of HCC is primarily due to the diversion of patients from the modern medical system due to their preference for Ngangas. Promotion of a form of medical syncretism respecting both systems might be an efficient policy to increase the attractiveness of modern medicine and to ultimately promote public health in Gabon. |
| Databáze: | OpenAIRE |
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