Spencer H C, Kaseje D C, Roberts J M, Huong A Y
Kenya Medical Research Institute, Clinical Research Centre, Nairobi.
Ann Trop Med Parasitol. 1987 Apr;81 Suppl 1:128-34. doi: 10.1080/00034983.1987.11812199.
A community-based malaria control programme was initiated in Saradidi, Kenya. One factor determining the utilization of treatment would be the symptoms felt to be diagnostic of malaria. The 12 most common diseases and 29 most common symptoms were identified by community members. Thirty-six randomly selected women were interviewed to determine association of the common diseases and symptoms; nine women were aged 15 to 29 years, nine women were 30 to 40 years, nine were 45 to 59 years and nine were 60 years or more. Women 60 years and older recognized a higher proportion of the diseases (P less than 0.0005) when compared with the other women of other ages. More than 90% of the women associated headache, fever, vomiting, joint pain, loss of appetite, tiredness and death with malaria. Measles and influenza were distinguished from malaria by rash and mouth ulcer for measles and by 'runny nose' and 'sneezing' for influenza. Analysis by average linkage hierarchical clusters revealed that malaria, influenza and measles were distinguished readily. The results suggest that if people in Saradidi do not obtain treatment from community health workers, it is not because they do not recognize the clinical symptoms of malaria.
肯尼亚萨拉迪迪启动了一项基于社区的疟疾控制项目。决定治疗利用率的一个因素是被认为可诊断疟疾的症状。社区成员确定了12种最常见的疾病和29种最常见的症状。随机选取36名女性进行访谈，以确定常见疾病和症状之间的关联；9名女性年龄在15至29岁之间，9名女性年龄在30至40岁之间，9名女性年龄在45至59岁之间，9名女性年龄在60岁及以上。与其他年龄段的女性相比，60岁及以上的女性识别出的疾病比例更高（P小于0.0005）。超过90%的女性将头痛、发烧、呕吐、关节疼痛、食欲不振、疲劳和死亡与疟疾联系起来。麻疹和流感可通过麻疹的皮疹和口腔溃疡以及流感的“流鼻涕”和“打喷嚏”与疟疾区分开来。通过平均连锁层次聚类分析表明，疟疾、流感和麻疹很容易区分。结果表明，如果萨拉迪迪的人们没有从社区卫生工作者那里获得治疗，那不是因为他们没有识别出疟疾的临床症状。
