Low perception of malaria risk among the Ra-glai ethnic minority in south-central Vietnam: implications for forest malaria control

Malaria Journal

Research

Annette Erhart¹  Umberto D'Alessandro¹  Wim Van Bortel¹  Koen Peeters Grietens²  Thang Ngo Duc³  Xa Nguyen Xuan³  Hung Le Xuan³  Joan Muela Ribera⁴  Truong Ba Nhat⁵  Ky Pham Van⁵ 

[1] Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium;Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium;Partners for Applied Social Sciences

[2]  PASS International, 3980, Tessenderlo, Belgium;National Institute for Malariology, Parasitology and Entomology, Luong The Vinh Street 245, Hanoi, Vietnam;Partners for Applied Social Sciences

[3]  PASS International, 3980, Tessenderlo, Belgium;Provincial Malaria Station, Ngo Gia Tu street 156 - Phan Rang City. Ninh Thuan Province, Vietnam;

关键词: Malaria;    Malaria Control;    Malaria Infection;    Malaria Risk;    National Malaria Control Programme;   

DOI  :  10.1186/1475-2875-9-23

 received in 2009-07-24, accepted in 2010-01-20,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundDespite Vietnam's success in reducing malaria mortality and morbidity over the last decade, malaria persists in the forested and mountainous areas of the central and southern provinces, where more than 50% of the clinical cases and 90% of severe cases and malaria deaths occur.MethodsBetween July 2005 and September 2006, a multi-method study, triangulating a malariometric cross-sectional survey and qualitative data from focused ethnography, was carried out among the Ra-glai ethnic minority in the hilly forested areas of south-central Vietnam.ResultsDespite the relatively high malaria burden among the Ra-glai and their general awareness that mosquitoes can transmit an unspecific kind of fever (84.2%), the use of bed nets, distributed free of charge by the national malaria control programme, remains low at the farmers' forest fields where the malaria risk is the highest. However, to meet work requirements during the labour intensive malaria transmission and rainy season, Ra-glai farmers combine living in government supported villages along the road with a second home or shelter at their slash and burn fields located in the forest. Bed net use was 84.6% in the villages but only 52.9% at the forest fields; 20.6% of the respondents slept unprotected in both places. Such low use may be explained by the low perception of the risk for malaria, decreasing the perceived need to sleep protected. Several reasons may account for this: (1) only 15.6% acknowledged the higher risk of contracting malaria in the forest than in the village; (2) perceived mosquito biting times only partially coincided with Anopheles dirus ss and Anopheles minimus A true biting times; (3) the disease locally identified as 'malaria' was hardly perceived as having an impact on forest farmers' daily lives as they were unaware of the specific kind of fevers from which they had suffered even after being diagnosed with malaria at the health centre (20.9%).ConclusionsThe progressive confinement of malaria to minority groups and settings in the Greater Mekong sub-region implies that further success in malaria control will be linked to research into these specific socio-cultural contexts. Findings highlight the need for context sensitive malaria control policies; not only to reduce the local malaria burden but also to minimize the risk of malaria spreading to other areas where transmission has virtually ceased.

【 授权许可】

CC BY   
© Peeters Grietens et al; licensee BioMed Central Ltd. 2010