Kroeger A, Meyer R, Mancheno M, González M
Liverpool School of Tropical Medicine, UK.
Trop Med Int Health. 1996 Dec;1(6):836-46. doi: 10.1111/j.1365-3156.1996.tb00119.x.
A malaria study was undertaken in 98 rural communities of the Pacific coast of Ecuador (n = 14), Colombia (n = 22) and Nicaragua (n = 62). In-depth interviews on people's knowledge and practice regarding malaria aetiology, symptoms and treatment were conducted and complemented by formal household interviews. On the basis of this information, an educational programme was set up which included the training of village health promoters and community workshops organized by the health workers and used a set of methods of interactive learning. After the baseline survey the communities were paired and randomly allocated to the intervention and control groups. Malaria education took place only in the intervention communities. At the start of the project people's knowledge about malaria-transmitting mosquitoes and malaria symptoms was correct and widespread in those areas where the community exposure to formal health services was pronounced. However, knowledge of the recommended dose of chloroquine was poor everywhere, and self-treatment of malaria episodes deficient. The educational intervention achieved a high level of participant satisfaction which was expressed in a high and continuous attendance rate at the monthly workshops. The knowledge of malaria aetiology and symptoms was 33-61% better in the intervention group than in the control group. Knowledge of the recommended doses of chloroquine increased significantly (34% in Ecuador, 93% in Colombia but not in Nicaragua) and correct use of chloroquine in the treatment of malaria episodes also improved (26% in Ecuador, 85% in Colombia). In Nicaragua the results were less satisfactory due to the short period of promotional activities and the health services' policy of delivering only supervised treatment to the population. It is concluded that health education should play a major role in malaria control.
在厄瓜多尔（n = 14）、哥伦比亚（n = 22）和尼加拉瓜（n = 62）太平洋沿岸的98个农村社区开展了一项疟疾研究。就疟疾病因、症状和治疗方面，对人们的知识和实践进行了深入访谈，并辅以正式的家庭访谈。基于这些信息，设立了一个教育项目，其中包括对乡村健康促进者的培训以及由卫生工作者组织的社区讲习班，并采用了一系列互动学习方法。在基线调查之后，将社区配对并随机分配到干预组和对照组。疟疾教育仅在干预社区进行。在项目开始时，在社区与正规卫生服务接触较多的那些地区，人们对传播疟疾的蚊子和疟疾症状的了解正确且广泛。然而，各地对氯喹推荐剂量的知晓情况都很差，疟疾发作时的自我治疗也不足。教育干预获得了较高的参与者满意度，这体现在每月讲习班的高出席率和持续出席率上。干预组对疟疾病因和症状的了解比对照组好33% - 61%。氯喹推荐剂量的知晓率显著提高（厄瓜多尔为34%，哥伦比亚为93%，但尼加拉瓜未提高），氯喹在治疗疟疾发作时的正确使用率也有所提高（厄瓜多尔为26%，哥伦比亚为85%）。在尼加拉瓜，由于推广活动时间短以及卫生服务部门仅对民众提供监督治疗的政策，结果不太令人满意。结论是健康教育应在疟疾控制中发挥主要作用。
