|Title:||Community concepts of malaria-related illness with and without convulsions in southern Ghana|
De Savigny, D.
|Keywords:||EMTREE medical terms: adult; behavior; childhood mortality; clinical feature; community; controlled study; convulsion; experience; fatality; female; Ghana; human; interview; major clinical study; malaria; malaria control; male; qualitative analysis; quantitative analysis; review; rural area; symptom|
|Citation:||Ahorlu, C. K., Koram, K. A., Ahorlu, C., De Savigny, D., & Weiss, M. G. (2005). Community concepts of malaria-related illness with and without convulsions in southern Ghana. Malaria Journal, 4.|
|Abstract:||Background: Malaria, both with or without convulsions, is a serious hardship for people living in endemic areas, especially in sub-Saharan Africa. Community references to malaria, however, may encompass other conditions, which was collectively designated malaria-related illness (MRI). Inasmuch as the presence or absence of convulsions reportedly affects timely help-seeking for malaria, a local comparison of these conditions is needed to inform malaria control. Methods: Vignette-based EMIC interviews (insider-perspective interviews) for MRI with convulsions (convulsion positive, MRI-CP) and without convulsions (convulsion negative, MRI-CN) were developed to study relevant features of MRI-related experience, meaning and behaviour in two rural communities in Ghana. These semi-structured interviews elicited both qualitative narrative and categorical codes for quantitative analysis. Interviews with 201 respondents were conducted. Results: The conditions depicted in the vignettes were well recognized by respondents and named with various local terms. Both presentations were considered serious, but MRI-CP was more frequently regarded potentially fatal than MRI-CN. More than 90.0% of respondents in both groups acknowledged the need to seek outside help. However, significantly more respondents advised appropriate help-seeking within 24 (p = 0.01) and 48 (p = 0.01) hours for MRI-CP. Over 50.0% of respondents responding to questions about MRI-CP identified MRI-CN as a cause of convulsions. Conclusion: Local comparison of MRI-CP and MRI-CN based on vignettes found a similar profile of reported categories of perceived causes, patterns of distress, help-seeking and preventive measures for both presentations. This differs from previous findings in sub-Saharan Africa, which assert communities regard the two conditions to be unrelated. The perceived relationships should be acknowledged in formulating strategies to control malaria through timely help-seeking and treatment to reduce childhood mortality. © 2005 Ahorlu et al; licensee BioMed Central Ltd.|
|Appears in Collections:||Noguchi Memorial Institute for Medical Research|
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