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首页> 外文期刊>Malaria Journal >Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study
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Local illness concepts and their relevance for the prevention and control of malaria during pregnancy in Ghana, Kenya and Malawi: findings from a comparative qualitative study

机译：加纳，肯尼亚和马拉维怀孕期间局部疾病的概念及其与疟疾预防和控制的关系：一项比较定性研究的结果

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Background In sub-Saharan Africa, the burden of morbidity and mortality linked to malaria during pregnancy (MiP) is significant and compounded by its unclear symptoms and links with other health problems during pregnancy. Mindful of the biomedical and social complexity of MiP, this article explores and compares local understandings of MiP and their links with other pregnancy-related health problems. Methods A comparative qualitative study was undertaken at four sites in three countries: Ghana, Malawi and Kenya. Individual and group interviews were conducted with pregnant women, their relatives, opinion leaders, other community members and health providers. MiP-related behaviours were also observed at health facilities and in local communities. Results Across the four sites, local malaria concepts overlapped with biomedically defined malaria. In terms of symptoms, at-risk groups, outcomes and aetiology of malaria during pregnancy, this overlap was however both site-specific and partial. Moreover, the local malaria concepts were not monolithic and their descriptions varied amongst respondents. The symptoms of pregnancy and malaria also overlapped but, for respondents, symptom severity was the distinguishing factor. Malaria was generally, though not universally, perceived as serious for pregnant women. Miscarriage was the most widely known outcome, and links with anaemia, low birth weight and congenital malaria were mentioned. Nonetheless, amongst many potential causes of miscarriage, malaria was not recognized as the most important, but rather interacted with other pregnancy-related problems. Conclusions Given the overlap of common pregnancy problems with the symptoms of malaria, and the limited association of malaria with its main outcomes, a comprehensive antenatal care programme is the most appropriate strategy for the provision of health education, prevention and treatment for MiP. Variations in locally shared understandings of MiP must however be taken into account when designing and promoting MiP intervention strategies.
机译：背景技术在撒哈拉以南非洲，怀孕期间与疟疾有关的发病率和死亡率负担很重（MiP），其症状不明确以及与怀孕期间其他健康问题的联系使情况更加复杂。考虑到MiP的生物医学和社会复杂性，本文探讨并比较了当地对MiP的理解及其与其他与妊娠相关的健康问题的联系。方法在三个国家（加纳，马拉维和肯尼亚）的四个地点进行了比较定性研究。对孕妇，其亲属，意见领袖，其他社区成员和卫生保健人员进行了个人和小组访谈。在医疗机构和当地社区也观察到与MiP有关的行为。结果在这四个地点，局部疟疾概念与生物医学定义的疟疾重叠。在症状，妊娠的高危人群，结局和疟疾的病因方面，这种重叠是针对特定部位和局部的。此外，当地的疟疾概念不是一成不变的，并且其描述在受访者中也有所不同。妊娠和疟疾的症状也有重叠，但对受访者而言，症状严重程度是主要因素。尽管并非普遍，但普遍认为疟疾对孕妇是严重的。流产是最广为人知的结局，并提到与贫血，低出生体重和先天性疟疾有关。尽管如此，在许多可能引起流产的原因中，疟疾并未被认为是最重要的，而是与其他与妊娠有关的问题相互作用的。结论鉴于常见的妊娠问题与疟疾症状重叠，并且疟疾与主要结果之间的联系有限，因此全面的产前保健计划是为MiP提供健康教育，预防和治疗的最合适策略。但是，在设计和推广MiP干预策略时，必须考虑到本地对MiP的理解存在差异。

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