From the sociocultural representation of people with dementia in the Republic of Congo, towards limited access to health care, results of the EPIDEMCA-FU program.

International audienceObjectives: The great age was long regarded as synonymous with wisdom in Africa. Nowadays, it is increasingly synonymous to: body that breaks down and senile dementia. Dementia is a public health problem in high-income countries and in low-and middle-income-countries. In the latter, where more than half of people with dementia (PWD) live, the disease is considered as an enigma by informal caregivers (IC) who sometimes abuse them and limit their access to health care because of pejoratives socio-cultural representations. The objective of the study was to analyze these representations could influence their access to health care and quality of life. Methods: An ethnological study was carried out in three months immersion in urban and rural areas to Congo. The non-directive interviews were conducted in local languages, associated by participant observations to analyze behaviors, gestures, discourses, to record phenomena that an interviewee could intentionally or not, fail to say and to control his statements. All data collected were analyzed at the time of their compilations. All non-directive interviews and participant observations were annotated and then transcribed. Before classifying these interviews into themes, a critical reading was made of them. Results: 36 life stories were conducted among IC. In urban area, 68.4% and 26.4% of PWD were treated respectively by syncretic church leaders (SCL) and traditional healers (TH). In rural area, 58.8% and 29.4% of PWD were treated respectively by TH and SCL. Only 5.3% of PWD was treated by general practitioner in urban area versus 11.8% by nurses in rural area. PWD were considered as possessed of evil spirits or demons, justifying the solicitation of to SCL and TH. The disease isn’t medicalized, the hospital isn’t a priority. Conclusion: Chance and ignorance have no place in the emergence of mental illnesses in traditional societies. Metaphysical causes are the most evoked, hence the inaccessibility of PWD to health care