Treatment-seeking practices for malaria in pregnancy among rural women in Mukono District, Uganda
Treatment-seeking practices for malaria in pregnancy among rural women in Mukono District, Uganda
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DOI：
10.1017/s0021932005007108
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发表时间：
2006-03-01
影响因子：
1.5
通讯作者：
Magnussen, P
中科院分区：
文献类型：
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作者：
Mbonye, AK;Neema, S;Magnussen, P
了解孕期疟疾的求医做法对于制定有效的方案以解决孕期疟疾发病率高的问题是必要的。这项研究评估了妇女对怀孕期间疟疾的看法、对怀孕和疟疾早期迹象的认识，以及穆科诺区寻求治疗的文化背景。在孕妇、非孕妇、青少年和男性中进行了焦点小组讨论(FGD)和关键线人访谈。结果显示，疟疾，在当地被称为omusujja，被认为是导致孕妇健康不佳的最常见原因。虽然疟疾通常表现为发烧，但一些孕妇在子宫中感到炎热，有或没有发烧的迹象，这种疾病，在当地被称为鼻疽，可能导致进行性虚弱，偶尔会导致流产，很少有受访者将其与疟疾联系起来。初发型、青少年和男性不被认为有患omusujja或Nabuguma的风险。同样，贫血和低出生体重与疟疾无关；事实上，脸色苍白被描述为怀孕的正常迹象。已婚女性面临着怀孕的文化和社会压力，这迫使她们隐瞒发烧、背痛、恶心、全身虚弱、食欲不振和呕吐等症状，直到她们确定这些都是由于怀孕造成的。然而，大多数妇女无法区分疟疾的症状和怀孕早期的症状。有一种看法认为，omusujja是怀孕的正常征兆，同时还有一种强烈的文化习俗，即使用草药和粘土作为治疗包括疟疾在内的妊娠疾病的首选手段。关于双胞胎和第一胎分娩的文化信仰和做法，再加上高昂的护理费用，使妇女无法在保健单位提供和使用其他服务。
Understanding treatment-seeking practices for malaria in pregnancy is necessary in designing effective programmes to address the high malaria morbidity in pregnancy. This study assessed women's perceptions on malaria in pregnancy, recognition of early signs of pregnancy and of malaria, and the cultural context in which treatment seeking takes place in Mukono District. Focus group discussions (FGD) and key informant interviews were conducted among pregnant women, non-pregnant women, adolescents and men. The results showed that malaria, locally known as omusujja, was perceived as the most common cause of ill health among pregnant women. Although malaria commonly presents with fever, some pregnant women feel hot in the womb with or without signs of fever and this illness, locally known as nabuguma, may lead to progressive weakness and occasionally to miscarriage and few respondents associated it with malaria. Primigravidae, adolescents and men were not considered at risk of omusujja or nabuguma. Similarly anaemia and low birth weight were not associated with malaria; in fact paleness was described as a normal sign of pregnancy. There are cultural and social pressures on married women to get pregnant and this forces them to conceal symptoms like feeling feverishness, backache, nausea, general weakness, loss of appetite and vomiting until they are sure these are due to pregnancy. Most women, however, could not differentiate symptoms of malaria from those of early pregnancy. There is a belief that omusujja is a normal sign of pregnancy and this is coupled with a strong cultural practice of using herbs and clays as a first resort to treat pregnancy ailments including malaria. The cultural beliefs and practices regarding delivery of twin and first births, coupled with the high cost of care, prevent women from delivering and using other services at health units.