“You’re losing your Ghanaianess”: understanding malaria decision-making among Africans visiting friends and relatives in the UK

Malaria Journal

Research

Ron H Behrens¹  Caroline OH Jones²  Penny E Neave³ 

[1] Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK;Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK;Kemri-Wellcome Trust Research Programme, Kilifi, Kenya;Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, University of Oxford, Oxford, UK;Department of Public Health, AUT University, Auckland, New Zealand;

关键词: Imported malaria;    Africans visiting friends and relatives;    Chemoprophylaxis;    Malaria prevention;    Malaria diagnosis;    Malaria treatment;    Migrant health;   

DOI  :  10.1186/1475-2875-13-287

 received in 2014-05-13, accepted in 2014-07-03,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundIn the UK, the majority of imported malaria infections occur in the London area among UK residents of African origin who travel to Africa visiting friends and relatives (VFRs). Effective malaria prevention measures are available but there is little understanding of the factors that enhance and constrain their use among VFRs.MethodsSemi-structured interviews were undertaken with Africans resident in London who visited friends and relatives in Nigeria and Ghana (n = 20) and with African VFRs recently treated for malaria (n = 6). Data collection took place between December 2007 and February 2011. Information on migration patterns and travel of respondents was collected and the data were analysed using a framework analysis approach.ResultsKnowledge of the link between mosquitoes and malaria was high. Factors influencing the use of mosquito avoidance methods included knowledge about the local environment, perceptions of the inevitability of contracting malaria, and a desire to fit with the norms of host families. Previous experience of bed nets, and the belief that more modern ways of preventing mosquito bites were available deterred people from using them. Chemoprophylaxis use was varied and influenced by: perceptions about continuing immunity to malaria; previous experiences of malaria illness; the cost of chemoprophylaxis; beliefs about the likely severity of malaria infections; the influence of friends in the UK; and, the way malaria is perceived and managed in Nigeria and Ghana. Malaria treatment was considered by many to be superior in Nigeria and Ghana than in the UK. A conceptual framework was developed to illustrate the manner in which these factors interact to affect malaria decisions.ConclusionsThe use of malaria prevention among VFRs needs to be understood not only in terms of individual risk factors but also in relation to the context in which decisions are made. For VFRs, malaria decisions are undertaken across two distinct social and environmental contexts and within the structural constraints associated with each. Strategies for reducing the burden of malaria among VFRs that ignore this complexity are likely to face challenges. New approaches that take account of contextual as well as individual factors are required.

【 授权许可】

CC BY   
© Neave et al.; licensee BioMed Central Ltd. 2014