Regmi Krishna, Kunwar Anju, Ortega Leonard
Faculty of Health and Social Sciences, Institute for Health Research, University of Bedfordshire, Luton, UK;
Faculty of Health and Social Sciences, Institute for Health Research, University of Bedfordshire, Luton, UK.
Infect Ecol Epidemiol. 2016 May 2;6:30822. doi: 10.3402/iee.v6.30822. eCollection 2016.
Malaria is one of the deadliest mosquito-borne diseases in the world. More than 80% of the total populations are at risk of malaria in the 22 countries in Asia and the Pacific. South Asia alone is home to an estimated 1.4 billion people at risk of contracting malaria. Despite the remarkable progress in reducing the burden of malaria, evidence of the disease based on knowledge of the social and cultural contexts from a South Asian perspective is limited. Our objective was to understand the knowledge, attitudes and beliefs about malaria in South Asian communities.
We conducted a systematic literature review, searching six databases, between 1990 and 2015, focusing on knowledge, attitudes and beliefs about malaria in South Asia. Databases were searched using both 'free terms' and 'index terms' funnelled using Boolean operators and truncations. Inclusion and exclusion criteria were set, and included papers were scrutinised, employing a critical appraisal tool to find the best available evidences to support the study purpose.
Evidence from 32 articles (26 quantitative, four qualitative and two mixed methods). General knowledge and awareness of the disease, its transmission, and control and preventative measures were generally found to be lacking amongst both the general public and healthcare professionals. In addition, the study shows that poor socio-economic factors - including limited access to services due to poor/limited availability - and issues of affordability are considered as major risk factors.
This review suggests the importance of increasing health awareness, mobilising the local or community healthcare professionals, for prevention as well as early detection and effective treatment of malaria among people who are at risk. Malaria is also a disease associated with poverty and socio-cultural factors; therefore, strong political will, wider partnerships between health and non-health sectors, and strengthening health systems' technical and managerial capabilities at all level of primary healthcare systems, is inevitable.
疟疾是世界上最致命的蚊媒疾病之一。在亚洲和太平洋地区的22个国家,超过80%的总人口面临疟疾风险。仅南亚就有大约14亿人有感染疟疾的风险。尽管在减轻疟疾负担方面取得了显著进展,但从南亚视角基于社会和文化背景知识的该疾病证据有限。我们的目标是了解南亚社区对疟疾的知识、态度和信念。
我们进行了一项系统的文献综述,在1990年至2015年期间搜索了六个数据库,重点关注南亚地区对疟疾的知识、态度和信念。使用布尔运算符和截断词通过“自由词”和“索引词”对数据库进行搜索。设定了纳入和排除标准,并对纳入的论文进行了审查,采用批判性评估工具来寻找支持研究目的的最佳现有证据。
来自32篇文章的证据(26篇定量研究、4篇定性研究和2篇混合方法研究)。一般公众和医疗保健专业人员普遍缺乏对该疾病及其传播、控制和预防措施的常识和认识。此外,研究表明,社会经济因素不佳——包括由于服务可及性差/有限而导致获得服务的机会有限——以及可负担性问题被视为主要风险因素。
本综述表明提高健康意识、动员当地或社区医疗保健专业人员对于预防以及对有风险人群进行疟疾的早期检测和有效治疗的重要性。疟疾也是一种与贫困和社会文化因素相关的疾病;因此,强大的政治意愿、卫生部门与非卫生部门之间更广泛的伙伴关系以及加强初级卫生保健系统各级卫生系统的技术和管理能力是不可避免的。