Biritwum R B, Welbeck J, Barnish G
Department of Community Health, Ghana Medical School, Korle Bu, Accra, Ghana.
Ann Trop Med Parasitol. 2000 Dec;94(8):771-8. doi: 10.1080/00034980020013037.
Two adjacent communities of differing socio-economic levels were selected, in Accra, Ghana, for the study of the home management of malaria. The youngest child in each selected household, each of which had a child aged < 5 years, was recruited for weekly follow-up, following informed consent. Malaria was the most common condition reported by the 'caregivers' (mothers of the subjects and others caring for the subjects) in each community, with 2.0 episodes of clinical malaria/child during the 9-month study. Most (89%) of the caregivers in the better-off community had been educated beyond primary-school level, but 55% of the caregivers in the poorer community had either received no formal education or only primary-school education. This difference was also reflected by the educational facilities provided to the children studied: 52% of the those in the better-off community attended nurseries, kindergartens or creches, compared with 8% of the children investigated in the poorer community. The proportion of caregivers who purchased drugs without prescription or used left-over drugs to treat clinical malaria in the children was higher in the poorer community (82% v. 53%), and a child from the poorer community was less likely to have been taken to a clinic or hospital to be treated for malaria than a child from the better-off community (27% v. 42%). During the follow-up period two children died, one from each community. Treatment of malaria in young children is likely to be less effective in the poorer community, where a lack of economic access to health services was demonstrated.
在加纳阿克拉，选取了两个社会经济水平不同的相邻社区，用于研究疟疾的家庭管理。在每个选定家庭中，若有年龄小于5岁的孩子，则招募该家庭中最小的孩子，并在获得知情同意后进行每周一次的随访。疟疾是每个社区“照顾者”（受试者的母亲及其他照顾受试者的人）报告的最常见病症，在为期9个月的研究中，每个孩子有2.0次临床疟疾发作。富裕社区中大多数（89%）照顾者接受过小学以上教育，但贫困社区中55%的照顾者未接受过正规教育或仅接受过小学教育。这一差异也反映在所研究儿童所享有的教育设施上：富裕社区中有52%的儿童上托儿所、幼儿园或日托中心，而贫困社区中接受调查的儿童这一比例为8%。贫困社区中未经处方购买药物或使用剩余药物治疗儿童临床疟疾的照顾者比例更高（82%对53%），而且贫困社区的儿童比富裕社区的儿童更不太可能被带到诊所或医院接受疟疾治疗（27%对42%）。在随访期间，有两个孩子死亡，每个社区各有一个。在贫困社区，幼儿疟疾治疗可能效果较差，因为该社区显示出缺乏获得医疗服务的经济途径。
