Biomedical colonialism or local autonomy?: local healers in the fight against tuberculosis

Analiza el papel de los agentes médicos autóctonos y sus conocimientos en las campañas antituberculosas contemporáneas en el África subsahariana. Sitúa la medicina contemporánea, llevada a cabo en África en la herencia cultural de la medicina colonial, para comprender el marco histórico en el que se desarrollaron, a partir de los años setenta del siglo XX, las estrategias de la Organización Mundial de la Salud de promoción y desarrollo de las medicinas 'tradicionales'. En los proyectos sanitarios analizados, se evalúan las prácticas médicas locales y se entrenan a los agentes autóctonos para integrarlos en actividades estrictamente biomédicas: identificación de síntomas, remisión a hospitales o supervisión de tratamientos farmacológicos.The article explores the role played by indigenous medical agents, and their knowledge, within contemporary tuberculosis campaigns in sub-Saharan Africa. To understand the historical framework within which the World Health Organization devised its strategies to promote and develop traditional medicine as of the 1970s, the article contextualizes contemporary medicine as a cultural legacy of colonial medicine. Under the public healthcare projects analyzed in the article, local medical practices were assessed and indigenous agents trained so they could take part in strictly biomedical activities, like symptom identification, referrals to hospitals, or supervision of drug treatments.Trabajo realizado para la obtención del Diploma de Estudios Avanzados (DEA) en el programa de doctorado Salud: Antropología e Historia, bajo la dirección de la profesora Rosa María Medina Doménech

An outbreak of meningococcal meningitis in Gauteng, Spring 1996

Objective. To describe a Neisseri.a meningitidis outbreak in Gauteng during the period 1 July to 31 December 1996.Design. A descriptive study.Setting. Patients with meningococcal meningitis in Gauteng who had been diagnosed by laboratory means, or notified during the period 1 July to 31 December 1996.Main outcome measures. Data including age, sex, date of admission to hospital, N. meningitidis serogroup and outcome were collected from Gauteng notification lists, South African Institute of Medical Research (SAIMR) records, a linelist compiled by the Gauteng Health Department, and hospital records.Results. A total of 201 patients was studied; of this number 87 (43%) had been notified. Seventy per cent of cases were below 30 years of age and 78% were male. More than half (54%) of the cases were from the West Rand. The case fatality rate for 70 cases of known outcome was 14%. Serotyping of 85 isolates.showed that a majority (76%) were serogroup A, with 57% being serogroup A clone 1-1.  Serogroup A clone Ill-I accounted for 14% of the typed isolates. All isolates weresensitive to penicillin With minimum inhibitory concentrations of < 0.05 /lg/ml.Conclusion. In 1996 Gauteng experienced an epidemic of serogroup A  meningococcal meningitis. The serotype that caused the majority of cases had been recorded in South Africa before, but serogroup A clone Ill-I, responsible for epidemics spreading across two continents, was recorded in South Africa for the first time. Notification of cases by health workers was inadequate in this epidemic