Kwarteng Alexander, Kenyon Kristi Heather, Opoku Asiedu Samuel, Garcia Regiane, Kini Priscilla, Osei-Poku Priscilla, Kwarteng Efiba Senkyire, Amewu Emmanuel Kobla Atsu
Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
PLOS Glob Public Health. 2023 Oct 31;3(10):e0002476. doi: 10.1371/journal.pgph.0002476. eCollection 2023.
Lymphatic filariasis (LF) is a mosquito-borne neglected tropical disease that is one of the leading global causes of permanent disability. To date, LF interventions have been largely biomedical, focusing on drug treatments to disrupt parasite transmission and manage disease morbidity. Although important, these Mass Drug Administration (MDA) programs neglect the significance of socio-economic burden to the health of LF patients, which are compounded by social stigmatization, discrimination and associated depressive illnesses. The MDA program also typically fails to engage with local community beliefs and perceptions of LF, which may differ markedly from biomedical explanations and may have fueled non-compliance to treatments which is one of the major challenges of the Mass Drug Administration program. LF is not only a biomedical issue but also a social issue and LF interventions need to understand people's world views and the contexts through which they interpret bodily maladies. Hence, an effective LF intervention must bring together both the biomedical and the social components. The goal of this exploratory study was to assist in refining a large qualitative study (currently underway) that seeks to integrate culturally appropriate LF interventions into current LF control programs in Ghana. In this paper, we discuss the findings of a pre-intervention, exploratory study aimed at gaining a baseline grasp of a local culturally informed understanding of lymphatic filariasis and the knowledge gaps looking at three endemic Ghanaian communities in the Ahanta West District. A structured questionnaire was employed to assess the wellbeing, social inclusion, and cultural understanding of LF with a geographic focus within LF-endemic areas in Ghana. Interestingly, 45.8% of the 72 participants reported to have received information about LF from health care providers and the MDA program but only 5 out of the 72 (6.9%) respondents believed that LF was transmitted by mosquitos. This baseline study revealed several alternative interpretations and misconceptions about the disease, as well as the social and economic impacts, and importantly, the need to integrate qualitative research to develop culturally appropriate interventions and increase engagement with existing control programs.
淋巴丝虫病（LF）是一种由蚊子传播的被忽视的热带疾病，是全球导致永久性残疾的主要原因之一。迄今为止，淋巴丝虫病的干预措施主要是生物医学方面的，重点是药物治疗，以阻断寄生虫传播并控制疾病发病率。尽管这些措施很重要，但这些大规模药物给药（MDA）项目忽视了社会经济负担对淋巴丝虫病患者健康的影响，而社会污名化、歧视及相关的抑郁症使这种影响更加复杂。MDA项目通常也未能考虑当地社区对淋巴丝虫病的看法和认知，这些看法和认知可能与生物医学解释有显著差异，并且可能导致了对治疗的不依从，这是大规模药物给药项目的主要挑战之一。淋巴丝虫病不仅是一个生物医学问题，也是一个社会问题，淋巴丝虫病的干预措施需要了解人们的世界观以及他们对身体疾病的解读背景。因此，有效的淋巴丝虫病干预措施必须将生物医学和社会成分结合起来。这项探索性研究的目的是协助完善一项大型定性研究（目前正在进行），该研究旨在将符合文化习俗的淋巴丝虫病干预措施纳入加纳当前的淋巴丝虫病控制项目。在本文中，我们讨论了一项干预前探索性研究的结果，该研究旨在初步了解加纳阿汉塔西区三个地方性流行社区对淋巴丝虫病的当地文化认知以及知识差距。我们采用了一份结构化问卷来评估加纳淋巴丝虫病流行地区居民的幸福感、社会包容度以及对淋巴丝虫病的文化理解，并以地理区域为重点。有趣的是，72名参与者中有45.8%报告称从医疗服务提供者和MDA项目中获得了有关淋巴丝虫病的信息，但72名受访者中只有5人（6.9%）认为淋巴丝虫病是由蚊子传播的。这项基线研究揭示了对该疾病的几种不同解读和误解，以及其社会和经济影响，重要的是，还揭示了整合定性研究以制定符合文化习俗的干预措施并提高对现有控制项目参与度的必要性。
