School of Public Health, James Cook University, Cairns, Australia.
Acta Trop. 2010 Oct;116(1):74-80. doi: 10.1016/j.actatropica.2010.05.012. Epub 2010 Jun 9.
Controlling dengue fever in Australia and internationally, relies heavily upon the actions of residents as well as community education and awareness of the risks. Although it has been well established in medical anthropology that the success of health interventions is highly dependent upon a clear grasp of lay knowledge of disease, limited attention has been given to lay understandings of dengue fever and its vectors in the extant literature. We begin addressing this hiatus through an examination of north Queensland residents' knowledge of the breeding habitats of Aedes aegypti mosquitoes. Building on the insights of earlier social research, we use factor analysis to examine the results of a series of randomly selected telephone surveys and compare responses over time and between cities. Our analysis confirms that many people assume that Ae. aegypti is ubiquitous in the landscape, that it lives and breeds not only around the home, but also in a variety of geographical spaces located beyond the suburban 'backyard', and beyond the control of local residents. Lay understandings appear to be placing people at risk from dengue, influencing the mosquito management practices of local residents and acting as a source of resistance to public health messages that focus on individual responsibility. A way forward through the provision of new information that challenges key assumptions is provided in the discussion. We argue that rather than dismissing lay understandings as ignorance, strategies, practices and policy based on a detailed understanding of this knowledge will mean that practitioners are better able to address these assumptions and will likely be more effective at educating the public of the risks posed by dengue.
在澳大利亚和国际上控制登革热，很大程度上依赖于居民的行动以及社区对疾病风险的教育和认识。尽管医学人类学已经充分证实，卫生干预措施的成功高度依赖于对疾病的基本知识的清晰把握，但在现有文献中，对登革热及其传播媒介的基本知识的关注有限。我们通过考察北昆士兰居民对埃及伊蚊滋生地的了解来开始解决这一差距。我们借鉴早期社会研究的见解，使用因子分析来检验一系列随机选择的电话调查的结果，并比较随时间和城市的变化的反应。我们的分析证实，许多人认为埃及伊蚊在景观中无处不在，它不仅在家庭周围生活和繁殖，而且在远离郊区“后院”的各种地理空间中生活和繁殖，并且超出了当地居民的控制范围。基本知识似乎使人们面临登革热的风险，影响当地居民的蚊虫管理实践，并成为对关注个人责任的公共卫生信息的抵制来源。在讨论中提供了通过提供新信息来克服关键假设的前进道路。我们认为，与其将基本知识视为无知而不屑一顾，不如基于对这些知识的详细了解制定策略、实践和政策，这将意味着从业者能够更好地应对这些假设，并有可能更有效地教育公众了解登革热带来的风险。
