International health specialists battling an outbreak of Marburg virus in Angola suspect unorthodox medical practices by local traditional healers may be contributing to the spread of the deadly disease.
The experts suggest that the healers, who lack medical training and supplies but substitute for doctors in many rural African communities, are administering injections in homes or in makeshift clinics with reused needles or syringes.
In the northern Angolan province of Uige, where 233 people have died of the Marburg virus, epidemiologists say they must convince people that such practices can mean death.
Pierre Formenty, an expert in hemorrhagic fevers like Marburg and a member of the World Health Organization's (WHO) team in Uige, said on Saturday that unsafe injections could explain why an average of three people per day continued to die of the Marburg virus a full month after the outbreak was identified and international teams arrived in Angola to battle it.
Although it is not clear what solutions the healers are injecting, specialists said, the virus can easily be transmitted from an infected to an uninfected person through a contaminated needle or syringe.
"I would say it is bit bizarre that we still have these high numbers per week," Formenty said in a telephone interview with reporters.
He said medical workers had developed a campaign against injections at home "asking people to use other kinds of medicines or to come to hospital or the health center to have a safe injection with new devices."
Another health care worker, who spoke on condition of anonymity, insisted that unnecessary shots are common in the province.
"There is a notion in Africa that if you haven't been given an injection, you haven't been treated," the worker said.
Formenty and other specialists said that while intense efforts to track possible cases and limit the potential for transmission of the virus were clearly helping to curtail the epidemic, it still was not clear whether the outbreak had peaked. At least 244 people have died of the virus so far, all but 11 of them in Uige.
"I would say that it's just a gut feeling that maybe things are going better in the sense that people are reporting more and more systematically the deaths," Formenty said.
Other encouraging signs, international specialists said, include the arrival on Thursday of a 28-member Angolan medical team in Uige and the opening of a fever ward at the provincial hospital, which had to be closed for disinfection.
"Certainly we are breaking the chain of transmission," said Mike Ryan, head of the WHO's alert and response operations.
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