Andrew Erin V W, Pell Christopher, Angwin Angeline, Auwun Alma, Daniels Job, Mueller Ivo, Phuanukoonnon Suparat, Pool Robert
Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain; Bridge HIV, San Francisco Department of Public Health, San Francisco, California, United States of America.
Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain; Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands.
PLoS One. 2015 Apr 20;10(4):e0119077. doi: 10.1371/journal.pone.0119077. eCollection 2015.
Malaria is the leading cause of illness and death in Papua New Guinea (PNG). Infection during pregnancy with falciparum or vivax malaria, as occurs in PNG, has health implications for mother and child, causing complications such as maternal anemia, low birth weight and miscarriage. This article explores knowledge, attitudes and practices concerning malaria during pregnancy and it's prevention in Madang, PNG, a high prevalence area.
As part of a qualitative study in Madang, exploring MiP, participatory techniques (free-listing and sorting) were conducted along with focus group discussions, in-depth interviews (with pregnant women, health staff and other community members) and observations in the local community and health facilities.
The main themes explored were attitudes towards and knowledge of MiP, its risks, and prevention. Although there was a general awareness of the term "malaria", it was often conflated with general sickness or with pregnancy-related symptoms. Moreover, many preventive methods for MiP were related to practices of general healthy living. Indeed, varied messages from health staff about the risks of MiP were observed. In addition to ideas about the seriousness and risk of MiP, other factors influenced the uptake of interventions: availability and perceived comfort of sleeping under insecticide-treated mosquito nets were important determinants of usage, and women's heavy workload influenced Chloroquine adherence.
The non-specific symptoms of MiP and its resultant conflation with symptoms of pregnancy that are perceived as normal have implications for MiP prevention and control. However, in Madang, PNG, this was compounded by the inadequacy of health staff's message about MiP.
疟疾是巴布亚新几内亚（PNG）疾病和死亡的主要原因。在PNG，孕妇感染恶性疟原虫或间日疟原虫会对母婴健康产生影响，导致诸如孕产妇贫血、低出生体重和流产等并发症。本文探讨了PNG高流行地区马当孕妇对疟疾的认识、态度和做法及其预防措施。
作为在马当开展的一项关于孕期疟疾（MiP）的定性研究的一部分，采用了参与性技术（自由列举和分类），并开展了焦点小组讨论、深入访谈（与孕妇、卫生工作人员和其他社区成员）以及在当地社区和卫生设施进行观察。
探讨的主要主题包括对MiP的态度和认识、其风险及预防措施。尽管人们普遍知晓“疟疾”一词，但它常与一般疾病或与妊娠相关症状相混淆。此外，许多MiP预防方法与一般健康生活方式相关。确实，观察到卫生工作人员关于MiP风险的信息各不相同。除了关于MiP严重性和风险的观念外，其他因素也影响了干预措施的采用：使用经杀虫剂处理的蚊帐的可获得性和感知舒适度是使用的重要决定因素，而女性繁重的工作量影响了对氯喹的依从性。
MiP的非特异性症状及其与被视为正常的妊娠症状的混淆对MiP的预防和控制产生影响。然而，在PNG的马当，卫生工作人员关于MiP的信息不足使情况更加复杂。
