Mburu F M, Spencer H C, Kaseje D C
Department of Community Health, University of Nairobi, Kenya.
Ann Trop Med Parasitol. 1987 Apr;81 Suppl 1:105-10. doi: 10.1080/00034983.1987.11812195.
To determine the changes in source of antimalarial treatment and perceptions about malaria after the initiation of a community-based malaria control programme in Saradidi, Kenya, two identical surveys were carried out; one in March 1982 (before the programme began in May 1982) and the other in December 1984. Three areas were involved: areas A and B had antimalarial treatment provided by village health helpers (VHH's) and area C had VHH's who did not provide treatment. Two groups of randomly selected women age 15 to 59 years were interviewed: 45 in survey 1 and 92 in survey 2. A decided change in the source of malaria treatment was observed. In the first survey, 52.9% of the respondents from areas A and B combined purchased antimalarial medicine from shops; other sources were government health facilities, mission clinics, and the Saradidi community clinic. By the second survey, 85.2% of the respondents in areas A and B obtained treatment from the VHH's; no significant change occurred in area C. In both surveys the leading reasons given for people purchasing drugs from shops was that the distance to health facilities was great, that no transport was available and that shops were open when emergencies occurred. The shopkeeper frequently advised which drug to take and the dosage as well as selling the drugs. For family illnesses of unknown aetiology most people (82.2% in survey 1 and 97.8%, in survey 2) went to a hospital or clinic. These results demonstrate that the malaria control programme in Saradidi has influenced both the source of antimalarials and the attitudes people have about malaria. In Saradidi, Kenya people chose to obtain antimalarial treatment and advice from community health workers.
为了确定在肯尼亚萨拉迪迪启动基于社区的疟疾控制项目后，抗疟治疗来源及对疟疾认知的变化情况，开展了两项相同的调查；一项于1982年3月（在该项目于1982年5月启动之前）进行，另一项于1984年12月进行。涉及三个区域：A区和B区由乡村卫生员（VHH）提供抗疟治疗，C区的乡村卫生员不提供治疗。随机选取两组年龄在15至59岁的女性进行访谈：调查1中有45人，调查2中有92人。观察到抗疟治疗来源有显著变化。在第一次调查中，A区和B区的受访者中，有52.9%的人从商店购买抗疟药物；其他来源包括政府卫生设施、教会诊所和萨拉迪迪社区诊所。到第二次调查时，A区和B区85.2%的受访者从乡村卫生员处获得治疗；C区未发生显著变化。在两项调查中，人们从商店购买药品的主要原因是距离卫生设施远、没有交通工具且在紧急情况发生时商店营业。店主经常会建议服用哪种药物、剂量是多少以及出售这些药物。对于病因不明的家庭疾病，大多数人（调查1中为82.2%，调查2中为97.8%）会前往医院或诊所。这些结果表明，萨拉迪迪的疟疾控制项目既影响了抗疟药物的来源，也影响了人们对疟疾的态度。在肯尼亚萨拉迪迪，人们选择从社区卫生工作者那里获得抗疟治疗和建议。
