PubMed · 10575670
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M M Meguid. A glimpse into the process.... https://doi.org/10.1016/s0899-9007(99)00203-8
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Most studies on community perceptions toward malaria have been undertaken in high-endemic countries, and studies from low-endemic countries have only recently been published. Similar information is also needed for hypoendemic countries such as Indonesia, to cope with the persistence of foci-endemic malaria in these regions. An applied qualitative method, Rapid Assessment Procedures, was employed during a 3-month intensive data collection period in Jepara district, Central Java province. Data were retrieved from 38 free-listings, 28 in-depth interviews, seven focus group discussions and unstructured observation. Qualitative thematic content analysis was applied. In this community, malaria (known as katisen or panas tis) was considered a common but minor illness. Insufficient understanding of malaria signs and symptoms in the subvillages likely leads to delay in illness recognition and treatment; not surprisingly self-treatment is common and the dosage most likely below the recommended dose. The health center was used but when it did not work, most people would shift back to traditional services due to cost considerations. Low understanding and acceptance of the causal link between the mosquito and malaria, likely leading to poor comprehension of preventive activities, as well as confusion of malaria with dengue fever, were identified. In conclusion, this study highlights a consistent gap between the common understanding and the biomedical description of malaria. If case management continues to be the main strategy in malaria control program, the emic perspective of the people must be well-integrated into the program. Likewise, interventions to improve home-treatment should also be developed.
BACKGROUND: The aim of this study was to investigate the vertical transmission rate of hepatitis C virus (HCV) in a Norwegian county and describe the clinical outcome of the infected infants. MATERIAL AND METHODS: Over the 1991-2000 period, 29,433 pregnant women gave birth to 37,893 children. Women born in high endemic areas and those with a history of drug abuse were offered anti-HCV testing. All anti-HCV positive specimens were subjected to supplementary testing by RIBA and PCR. RESULTS: Hepatitis C virus antibodies were detected in 61 women who delivered 83 children over this ten-year period. 61% of the women were HCV-RNA positive. The transmission rate was 5.0% (8.3% for HCV-RNA positive mothers). None of the HCV-RNA negative mothers transmitted the virus to their offspring. 95% of the anti-HCV positive mothers had a history of drug abuse; none came from high endemic areas. All mothers tested negative for HIV and hepatitis B virus (HBs antigen) during pregnancy. HCV antibodies persisted up to 18 months after birth in non-infected infants, but most of them tested negatively within one year of age. All infected infants tested negative by PCR at birth, and only one out of four had persistently elevated alanine amino-transferase. INTERPRETATION: Our data is consistent with other studies of vertical transmission of HCV. Anti-HCV screening of larger groups of pregnant women is warranted to investigate the true incidence of vertical transmission in our population.
Treponemal diseases comprise venereal syphilis (Treponema pallidum subsp. pallidum) and the endemic (non-venereal) treponematoses, i.e. yaws (T. pallidum subsp. pertenue), endemic syphilis (T. pallidum subsp. endemicum) and pinta (T. carateum). Treponemal diseases are distinguished on the basis of epidemiological characteristics and clinical manifestations. They are at present indistinguishable by morphological, immunological or serological methods. Several minor genetic differences have been identified among the subspecies. The endemic treponematoses have not yet been eliminated and are currently thought to affect at least 2.5 million persons. Renewed action towards the elimination of these diseases should be undertaken.