Understanding the community perspectives of trachoma: The Gambia as a case study.
Understanding the community perspectives of trachoma: The Gambia as a case study.
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DOI：
10.1076/opep.8.2.163.4161
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发表时间：
2001-07-01
影响因子：
1.8
通讯作者：
Hart, A
中科院分区：
文献类型：
--
作者：
Ajewole, J F;Faal, H B;Hart, A
在过去的几十年里，沙眼吸引了大量的研究兴趣和文献。也许，研究最少的领域是这种疾病的社会方面。在全球范围内控制沙眼的大多数主要制约因素似乎与该疾病的这一方面有关。最近，在冈比亚进行了一项研究，目的是突出沙眼的社会文化决定因素。本研究采用焦点小组讨论和半结构化访谈的定性方法，对5个农村社区的Jolas族和Manjagos族两个传统民族进行了调查。我们的研究结果表明，在当地人群中，对沙眼活动性炎症期的慢性性质的理解似乎很差。但更重要的是，这种儿童感染与成人倒睫导致的失明之间缺乏精神上的联系。这可能解释了为什么这些社区的人们很难看到在治疗活动性炎症性沙眼时需要长期使用抗生素眼膏。此外，当地关于该病病因的观念往往迫使人们首先寻求传统的草药疗法，尽管他们中间有足够的知识和经验，认为现代治疗方法可以治愈该病，例如对倒睫进行矫正眼睑手术。人们对卫生服务的这种矛盾态度似乎是非洲许多地方社区的普遍现象，也许取决于当地人民对这种疾病的看法，这种看法因地而异。我们得出的结论是，尽管存在这些限制，但要实现消除沙眼的既定目标，任何干预策略都必须得到社区的支持和参与，为了实现这一目标，卫生保健提供者需要更好地了解社区对该疾病的看法。
Trachoma has justifiably attracted an incredibly large amount of research interest and literature over the last several decades. Perhaps, the area which is least explored is the social aspect of the disease. Most of the major constraints to trachoma control on the global scale appear to be concerned with this aspect of the disease. Recently, a study was conducted in The Gambia with the aim of highlighting the socio-cultural determinants of trachoma. We applied qualitative methods of Focus Group Discussion and Semi-structured interview to explore the local people's concepts of the disease among two traditional ethnic groups, the Jolas and the Manjagos, in five rural communities. Our results show that there appears to be a poor understanding of the chronic nature of the active inflammatory phase of trachoma among the local people. But more importantly, there is a lack of mental connection between this childhood infection and blindness resulting from trichiasis in adults. This probably explains why it is difficult for the people in these communities to see the need for prolonged use of antibiotic eye ointment as required in the treatment of active inflammatory trachoma. Moreover, the local concepts about the cause(s) of the disease tend to compel the people to seek the traditional herbal remedies first, though there is adequate knowledge and experience among them that modern methods of treatment may produce cure, as in the case of corrective lid surgery for trichiasis. This ambivalent attitude of the people to health services appear to be a universal phenomenon in many local communities in Africa, and perhaps hinges on the local people's perspective of the disease, which varies from place to place. We conclude that for any intervention strategy to achieve the set goals of eliminating trachoma in spite of these constraints, community support and participation is essential, and in order to achieve this, the health care provider needs to have a better understanding of the community perspectives of the disease.