‘Entunuka’ is not caused by witchcraft

Oct 25, 2009

THE beliefs that people have about the causes and treatment of paronychia, commonly known as entunuka in Luganda, are telling. On a local FM radio station a few days ago, the host asked the listeners for their views on what form of traditional or modern m

By Owen Wagabaza

THE beliefs that people have about the causes and treatment of paronychia, commonly known as entunuka in Luganda, are telling. On a local FM radio station a few days ago, the host asked the listeners for their views on what form of traditional or modern medicine is suitable for the treatment of paronychia.

About 99% of the callers argued that traditional medicine is far better in the treatment of the disease compared to modern medicine. Interestingly, each of the over 30 callers had a different remedy to the problem, some as bizarre as pointing the infected finger or toe in the hole of a pit latrine or inserting the infected finger in a woman’s private parts.

When interviewed, Matiya Kalunda Lwanga, a herbalist at St. Balikudembe Market, said he treats the disease using warm tobacco leaves tied around the infected part in the mornings and evenings, till the situation improves.

What medics say
According to Dr. Herbert Ssemuwanga of Makerere University Hospital, paronychia is often a tender infection of inflammation around the base of the nail fold. It can start suddenly (acute paronychia) or gradually (chronic paronychia).

“Acute paronychia develops over a few hours when a nail fold becomes painful, red and swollen, with yellow pus under the cuticle,” he says.

In some cases, fever and painful glands under the armpits may accompany severe paronychia. Chronic paronychia, Ssemuwanga says, is gradual and difficult to treat.

“It may start in one nail fold, but often spreads to others. Each affected nail fold becomes swollen, red and tender. Sometimes pus can be expressed from under the cuticle. The nail may become distorted and ridged, yellow, green or brittle,” says Dr. Ssemuwanga.

Causes
Paronychia is mostly caused by injury to the area, for example, from biting, picking a hangnail or trimming or pushing back the cuticle.

“When bacteria gets in contact with the injured area, bacterial paronychia develops, a specific type of yeast results into candidal paronychia and fungus results into fungal paronychia.

People who constantly wet their hands such as hairdressers, nurses, and housewives, are at a higher risk,” says Dr. Ssemuwanga.

Symptoms
The main symptom is a painful, red, swollen area around the nail, often at the cuticle. There may be pus-filled blisters, especially if it is a bacterial infection.

Treatment
Dr. Ssemuwanga says soaking the infected nail in hot water two or three times a day, helps reduce swelling and pain. Antibiotics may also be prescribed. In severe cases, the doctor may cut and drain the blister and part of the nail may need to be removed.

In fungal paronychia, anti-fungal medicine may be prescribed. The patient may also be advised to keep the hands dry by apply a skin-drying substance such as Castellani’s paint.

Facts about paronychia
People who have constantly wet hands such as hairdressers, nurses, bar tenders and housewives are at a high risk

Mild infections can be treated with warm soaks for several days.
lSometimes a nail bed abscess will drain on its own

Pain, redness and tenderness are the most common symptoms.

Neglected infections may result into infections tracking up the finger. This requires extensive surgery and poses other health risks, especially to people with diabetes, circulatory or immune system problems.

Prevention
Care for the nails and the skin around them properly.
Avoid damaging the nails or finger tips. Since the nails grow slowly, an injury can last a month.

Do not bite or pick nails
Protect nails from exposure to detergents and chemicals by using protective rubber or plastic gloves

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