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2016 ; 11
(3
): e0151068
Nephropedia Template TP
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English Wikipedia
"Tazomoka Is Not a Problem" Local Perspectives on Malaria, Fever Case Management
and Bed Net Use in Madagascar
#MMPMID26943672
Mattern C
; Pourette D
; Raboanary E
; Kesteman T
; Piola P
; Randrianarivelojosia M
; Rogier C
PLoS One
2016[]; 11
(3
): e0151068
PMID26943672
show ga
BACKGROUND: Although its incidence has been decreasing during the last decade,
malaria is still a major public health issue in Madagascar. The use of Long
Lasting Insecticidal Nets (LLIN) remains a key malaria control intervention
strategy in Madagascar, however, it encounters some obstacles. The present study
aimed to explore the local terminology related to malaria, information channels
about malaria, attitude towards bed nets, and health care seeking practices in
case of fever. This article presents novel qualitative findings about malaria.
Until now, no such data has been published for Madagascar. METHODS: A comparative
qualitative study was carried out at four sites in Madagascar, each differing by
malaria epidemiology and socio-cultural background of the populations.
Seventy-one semi-structured interviews were conducted with biomedical and
traditional caregivers, and members of the local population. In addition,
observations of the living conditions and the uses of bed net were conducted.
RESULTS: Due to the differences between local and biomedical perspectives on
malaria, official messages did not have the expected impact on population in
terms of prevention and care seeking behaviors. Rather, most information retained
about malaria was spread through informal information circulation channels. Most
interviewees perceived malaria as a disease that is simple to treat. Tazomoka
("mosquito fever"), the Malagasy biomedical word for malaria, was not used by
populations. Tazo ("fever") and tazomahery ("strong fever") were the terms more
commonly used by members of the local population to refer to malaria related
symptoms. According to local perceptions in all areas, tazo and tazomahery were
not caused by mosquitos. Each of these symptoms required specific health
recourse. The usual fever management strategies consisted of self-medication or
recourse to traditional and biomedical caregivers. Usage of bed nets was
intermittent and was not directly linked to protection against malaria in the
eyes of most Malagasy people. CONCLUSIONS: This article highlights the
conflicting understanding of malaria between local perceptions and the biomedical
establishment in Madagascar. Local perceptions of malaria present a holistic
vision of the disease that includes various social and cultural dimensions,
rather than reflecting one universal understanding, as in the biomedical image.
The consideration of this "holistic vision" and other socio-cultural aspects
surrounding the understanding of malaria is essential in implementing successful
control intervention strategies.