Institute of Health and Society, Department of General Practice and Community Medicine, Section for Medical Anthropology, University of Oslo, P.O. Box 1130 Blindern, N-0318 Oslo, Norway.
Malar J. 2012 Jan 11;11:15. doi: 10.1186/1475-2875-11-15.
This article discusses the link between disability and malaria in a poor rural setting. Global malaria programmes and rehabilitation programmes are organized as vertical and separate programmes, and as such they focus on prevention, cure and control, and disability respectively. When looking at specific conditions and illnesses, the impairing long-term consequences of illness incidents during childhood are not questioned.
The study design was ethnographic with an open, exploratory approach. Data were collected in Mangochi District in Malawi through qualitative in-depth interviews and participant observation.
Despite a local-based health service system, people living in poor rural areas are confronted with a multitude of barriers when accessing malaria prevention and treatment. Lack of skilled health personnel and equipment add to the general burden of poverty: insufficient knowledge about health care, problems connected to accessing the health facility in time, insufficient initiatives to prevent malaria attacks, and a general lack of attention to the long term disabling effects of a malaria attack.
This study points to the importance of building malaria programmes, research and statistics that take into consideration the consequences of permanent impairment after a malaria attack, as well as the context of poverty in which they often occur. In order to do so, one needs to develop methods for detecting people whose disabilities are a direct result of not having received health services after a malaria episode. This may be done through qualitative approaches in local communities and should also be supplemented by suitable surveys in order to estimate the problem on a larger scale.
本文讨论了贫困农村地区残疾与疟疾之间的联系。全球疟疾规划和康复规划分别作为垂直和独立的规划进行组织，分别侧重于预防、治疗和控制以及残疾问题。在考虑具体条件和疾病时，并没有质疑儿童时期患病事件对长期造成的致残后果。
本研究采用人种学设计，采用开放、探索性方法。数据通过定性深入访谈和参与式观察在马拉维曼戈切区收集。
尽管有基于当地的卫生服务系统，但生活在贫困农村地区的人们在获得疟疾预防和治疗方面面临着诸多障碍。缺乏熟练的卫生人员和设备加剧了贫困的总体负担：对医疗保健知识的了解不足、及时获得卫生设施的问题、预防疟疾发作的措施不足，以及对疟疾发作后长期致残影响的普遍关注不足。
本研究表明，必须制定考虑到疟疾发作后永久性损伤后果以及贫困背景的疟疾规划、研究和统计数据，因为这些问题常常同时发生。为了做到这一点，需要开发方法来发现那些因疟疾发作后未获得医疗服务而直接导致残疾的人。这可以通过在当地社区进行定性方法来实现，还应辅以适当的调查，以便在更大范围内估计问题的规模。
