[Sociocultural dimension of epilepsy (kirikirimasien) in a Bambara rural area (Mali)].

The anthropological study of kirikirimasien (epilepsy) in Mali constitutes an integral part of a research programme devoted to the epidemiology of epilepsy and onchocerciasis in Mali. This programme is run jointly by scientists of the Ecole Nationale de Médecine et de Pharmacie (National School of Medicine and Pharmacy) of Bamako, Mali, and the Faculté de Médecine (Faculty of Medicine) of Marseilles, France. Preliminary results of the anthropological study are presented, based on the qualitative analysis of 132 interviews, conducted over 6 months. Those interviewed were mainly persons affected by kirikirimasien, but included members of the family circle, traditional healers, and outsiders as well. Participatory interview techniques used the national language bambara. The interviews were unstructured and semi-structured so as to identify themes in the bambara language concerning kirikirimasien. Two dominant trends were identified, concerning the aetiology and nosography of the disease, and the social dimension of kirikirimasien, respectively. In terms of aetiology and nosography, diagnosis, contamination and appelation are--in order of priority--the most important aspects of the disease. Yet the social dimension of kirikirimasien appears largely to surpass its aetiological and nosographic aspects. The social dimension is crucial to the anthropological understanding of kirikirimasien. This was amply illustrated by various references which arose during the interviews. First, how is the notion of contamination represented and which practices are associated with it? Second, invalidity and handicap appear to play an essential role in the way people deal with the disease. The notion of tolerance in the bambara environment is also addressed, mainly through a spatial study of the adherence of the person affected by the disease (family, village and outsiders). The third part of the study deals with the social understanding of kirikirimasien and looks at how those affected are cared for, both within their social setting and in terms of seeking treatment.