加纳南部关于伴有或不伴有惊厥的疟疾相关疾病的社区概念。
Community concepts of malaria-related illness with and without convulsions in southern Ghana.
作者信息
Ahorlu Collins K, Koram Kwadwo A, Ahorlu Cynthia, de Savigny Don, Weiss Mitchell G
机构信息
Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
出版信息
Malar J. 2005 Sep 27;4:47. doi: 10.1186/1475-2875-4-47.
BACKGROUND
Malaria, both with or without convulsions, is a serious hardship for people living in endemic areas, especially in sub-Saharan Africa. Community references to malaria, however, may encompass other conditions, which was collectively designated malaria-related illness (MRI). Inasmuch as the presence or absence of convulsions reportedly affects timely help-seeking for malaria, a local comparison of these conditions is needed to inform malaria control.
METHODS
Vignette-based EMIC interviews (insider-perspective interviews) for MRI with convulsions (convulsion positive, MRI-CP) and without convulsions (convulsion negative, MRI-CN) were developed to study relevant features of MRI-related experience, meaning and behaviour in two rural communities in Ghana. These semi-structured interviews elicited both qualitative narrative and categorical codes for quantitative analysis. Interviews with 201 respondents were conducted.
RESULTS
The conditions depicted in the vignettes were well recognized by respondents and named with various local terms. Both presentations were considered serious, but MRI-CP was more frequently regarded potentially fatal than MRI-CN. More than 90.0% of respondents in both groups acknowledged the need to seek outside help. However, significantly more respondents advised appropriate help-seeking within 24 (p = 0.01) and 48 (p = 0.01) hours for MRI-CP. Over 50.0% of respondents responding to questions about MRI-CP identified MRI-CN as a cause of convulsions.
CONCLUSION
Local comparison of MRI-CP and MRI-CN based on vignettes found a similar profile of reported categories of perceived causes, patterns of distress, help-seeking and preventive measures for both presentations. This differs from previous findings in sub-Saharan Africa, which assert communities regard the two conditions to be unrelated. The perceived relationships should be acknowledged in formulating strategies to control malaria through timely help-seeking and treatment to reduce childhood mortality.
背景
疟疾，无论有无惊厥，对于生活在流行地区的人们来说都是一项严重的困苦，尤其是在撒哈拉以南非洲地区。然而，社区提及的疟疾可能包含其他病症，这些病症统称为疟疾相关疾病（MRI）。鉴于据报道惊厥的有无会影响疟疾的及时就医，因此需要对这些病症进行本地比较，以为疟疾控制提供参考。
方法
针对有惊厥（惊厥阳性，MRI-CP）和无惊厥（惊厥阴性，MRI-CN）的MRI开展基于案例的主位访谈（内部视角访谈），以研究加纳两个农村社区中与MRI相关的经历、意义和行为的相关特征。这些半结构化访谈得出了定性叙述和用于定量分析的分类编码。对201名受访者进行了访谈。
结果
案例中描述的病症被受访者很好地识别出来，并用各种当地术语命名。两种表现形式都被认为很严重，但MRI-CP比MRI-CN更常被认为有潜在致命性。两组中超过90.0%的受访者承认需要寻求外部帮助。然而，对于MRI-CP，显著更多的受访者建议在24小时（p = 0.01）和48小时（p = 0.01）内寻求适当帮助。在回答关于MRI-CP问题的受访者中，超过50.0%的人将MRI-CN识别为惊厥的一个原因。
结论
基于案例对MRI-CP和MRI-CN进行的本地比较发现，两种表现形式在报告的感知病因类别、痛苦模式、寻求帮助和预防措施方面具有相似的概况。这与撒哈拉以南非洲地区以前的研究结果不同，以前的研究结果称社区认为这两种病症无关。在制定通过及时寻求帮助和治疗来控制疟疾以降低儿童死亡率的策略时，应承认这种感知到的关系。
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