Yadav S P, Sharma R C, Joshi V
Desert Medicine Research Centre, New Pali Road, Jodhpur, India.
J Commun Dis. 2007 Mar;39(1):57-64.
Malaria remains to be the most important cause of morbidity and mortality in India and in many other tropical countries with approximately 2 to 3 million new cases arising every year. In spite of arid conditions prevailing in desert part of Rajasthan, malaria is a major public health problem. A longitudinal study on social determinants of malaria has been undertaken in different villages of Ramgarh PHC of Jaisalmer district, Rajasthan. The study aims to know treatment seeking behabiour of malaria patients in the desert communities which is significantly different than the non-desert part of India. Out of 60 villages, 12 villages and 573 malaria patients were selected randomly. Interview technique was used for data collection. Information was recorded on pre-tested schedules. Self diagnosis 423 (73.8%) was more common among the respondents and 443 (77.3%) had taken treatment at home with local herbal remedies as the first treatment action. Desert population was not used to laboratory test for the malaria diagnosis. Symptoms based treatment was practised. They used private and government health facilities for the treatment of malaria. Self diagnosis for malaria was common but practised more by the poorer households. A large part of the population did not complete the full course of malaria treatment as a result drug resistance was more common. They did not use the government health facility as a first step of malaria treatment. There is need for health education with campaign emphasizing the role of mosquitoes in malaria transmission and the need for prompt medical intervention. The use of Government health services for the diagnosis and treatment of malaria by the poor should be encouraged through appropriate information, education and communication (IEC) which on the long run will be more cost effective for desert population under the national malaria control programme.
疟疾仍然是印度以及许多其他热带国家发病和死亡的最重要原因，每年约有200万至300万新病例出现。尽管拉贾斯坦邦沙漠地区气候干旱，但疟疾仍是一个重大的公共卫生问题。在拉贾斯坦邦斋沙默尔 district的拉姆加尔初级卫生保健中心的不同村庄开展了一项关于疟疾社会决定因素的纵向研究。该研究旨在了解沙漠社区疟疾患者的就医行为，这与印度非沙漠地区有显著差异。在60个村庄中，随机选取了12个村庄和573名疟疾患者。采用访谈技术收集数据。信息记录在预先测试的表格上。自我诊断在受访者中更为常见，有423人（73.8%）进行了自我诊断，443人（77.3%）首先采取了在家使用当地草药治疗的措施。沙漠地区的居民不习惯通过实验室检测来诊断疟疾。实行基于症状的治疗方法。他们利用私立和政府卫生设施治疗疟疾。疟疾的自我诊断很常见，但贫困家庭更为普遍。很大一部分人口没有完成疟疾治疗的全过程，因此耐药性更为常见。他们没有将政府卫生设施作为疟疾治疗的首选。需要开展健康教育活动，强调蚊子在疟疾传播中的作用以及及时进行医疗干预的必要性。应通过适当的信息、教育和宣传（IEC）鼓励穷人利用政府卫生服务诊断和治疗疟疾，从长远来看，这在国家疟疾控制计划下对沙漠地区的居民将更具成本效益。
