Prall Sean, Lopes Aparicio
Department of Anthropology, University of California, Los Angeles, USA.
OnePencil Namibia, Opuwo, Namibia.
Malar J. 2025 May 7;24(1):143. doi: 10.1186/s12936-025-05382-x.
As Namibia attempts to eradicate locally transmitted cases of malaria, epidemiological strategies, interventions, and outreach require a sound understanding of indigenous knowledge and practice. Research describing local explanatory models of disease can be of value in these efforts by elucidating how disease is interpreted and treated. To understand how perceptions of malaria infection and treatment may influence health-seeking behaviour, cultural models of the disease were explored in two ethnic groups in rural northwest Namibia.
Mixed-sex focus groups of 4-8 individuals were conducted in the Kunene region of Namibia. All participants were either Himba or Herero and lived between 14 and 57 km of the regional town centre of Opuwo. Discussion prompts were designed to assess knowledge, beliefs, and norms about malaria, including causes, symptoms, treatment, and prevention.
Focus groups reported universal difficulty in discrimination between malaria and respiratory infections, the former of which was often only diagnosed at the hospital. Some recognized mosquitoes as the source of malaria, particularly the more formally educated Herero, but all also reported other causes. Notably these causes, including dietary and temperature-based origins, were considered unavoidable. Himba and Herero believed that malaria was infectious person-to-person and incorrectly believed that malaria was most common during the wintertime. Both groups also relied on a number of traditional remedies to alleviate symptoms, which were used as primary treatment, with formal healthcare treatment typically only sought when the illness progressed.
These results highlight significant differences between local cultural models and biomedical ones that could be detrimental to malaria eradication efforts. Kunene pastoralists have limited understanding of the causes of malaria, and beliefs about environmental and dietary causes may undermine attempts at prevention. Seeking healthcare solutions to malaria was normative, but secondary to use of at home traditional remedies. These findings indicate public health outreach and information campaigns are needed, particularly in rural groups with less formal education.
随着纳米比亚努力消除疟疾的本地传播病例，流行病学策略、干预措施和宣传工作需要深入了解本土知识和实践。描述疾病的当地解释模型的研究，通过阐明疾病是如何被解释和治疗的，在这些努力中可能具有价值。为了了解对疟疾感染和治疗的认知如何影响就医行为，在纳米比亚西北部农村的两个族群中探索了该疾病的文化模型。
在纳米比亚的库内内地区，组织了由4至8人组成的混合性别焦点小组。所有参与者均为辛巴族或赫雷罗族，居住在距奥普沃地区镇中心14至57公里的范围内。讨论提示旨在评估关于疟疾的知识、信念和规范，包括病因、症状、治疗和预防。
焦点小组报告称，普遍难以区分疟疾和呼吸道感染，前者通常只有在医院才能确诊。一些人认识到蚊子是疟疾的来源，特别是受教育程度较高的赫雷罗族，但所有人也都提到了其他病因。值得注意的是，这些病因，包括饮食和基于温度的病因，被认为是不可避免的。辛巴族和赫雷罗族都认为疟疾具有人际传染性，并且错误地认为疟疾在冬季最为常见。两组还都依赖一些传统疗法来缓解症状，这些疗法被用作主要治疗方法，通常只有在病情进展时才寻求正规医疗治疗。
这些结果凸显了当地文化模型与生物医学模型之间的显著差异，这可能对疟疾消除努力产生不利影响。库内内的牧民对疟疾病因的了解有限，关于环境和饮食病因的信念可能会破坏预防工作的努力。寻求疟疾的医疗解决方案是常态，但仅次于在家中使用传统疗法。这些发现表明需要开展公共卫生宣传和信息活动，特别是在受正规教育较少的农村群体中。
