McCombie S C
Department of Anthropology and Geography, Georgia State University, Atlanta, GA 30303-3083, USA.
Health Policy Plan. 2002 Dec;17(4):333-44. doi: 10.1093/heapol/17.4.333.
Malaria remains an important cause of death, especially in sub-Saharan Africa. Self-treatment with antimalarial drugs is a common practice that raises important issues for policy-makers. A number of important questions concerning factors related to self-treatment, adequacy of self-treatment and the role of self-treatment in malaria mortality remain unanswered. Although there are some common patterns, there is considerable diversity in treatment practices, even within a single country. Social science research on malaria treatment needs to move beyond description to evaluation of interventions. This will require a greater degree of methodological rigour and more attention to the generation of data that can be compared across time periods and studies. Definitions of malaria cases and the role of local disease categories in identifying cases need to be made more explicit. Illnesses should be classified by severity, using measures of perceived severity as well as biomedical signs of severity. Each treatment step should be considered in terms of four levels of analysis: who provided the treatment or advice, what the treatment was, where it was obtained and when it was taken in relationship to onset of illness.
疟疾仍然是一个重要的死因，尤其是在撒哈拉以南非洲地区。使用抗疟药物进行自我治疗是一种常见做法，这给政策制定者带来了重要问题。一些与自我治疗相关的因素、自我治疗的充分性以及自我治疗在疟疾死亡率中的作用等重要问题仍未得到解答。尽管存在一些常见模式，但治疗方法存在相当大的差异，即使在同一个国家也是如此。关于疟疾治疗的社会科学研究需要从描述转向对干预措施的评估。这将需要更高程度的方法严谨性，并更加关注能够在不同时间段和研究中进行比较的数据生成。疟疾病例的定义以及当地疾病类别在病例识别中的作用需要更加明确。疾病应根据严重程度进行分类，使用感知严重程度的衡量标准以及严重程度的生物医学体征。每个治疗步骤应从四个分析层面来考虑：谁提供了治疗或建议、治疗是什么、在哪里获得以及与疾病发作的时间关系。
