Community response to intermittent preventive treatment delivered to infants (IPTi) through the EPI system in Manhiça, Mozambique

作者: Robert Pool , Khatia Munguambe , Eusebio Macete , Pedro Aide , Geraldina Juma

DOI: 10.1111/J.1365-3156.2006.01725.X

关键词: HumanitiesPsychologyTropical medicineCommunity responseHealth knowledge

摘要: Summary Objective  To describe attitudes to the expanded programme on immunization (EPI) and intermittent preventive treatment in infants (IPTi), perceptions of relationship between them. In particular, whether introduction IPTi negatively affects community to, or use of, EPI; or, conversely, if so how, concurrent delivery influences IPTi. Methods  Anthropological study carried out context a trial with sulphadoxine–pyrimethamine delivered alongside routine EPI vaccinations. We used open in-depth interviews, semi-structured interviews participant observation, conducted both clinic settings. Results  was generally acceptable, spite initial resistance. Perceived negative aspects did not affect EPI, misinterpreted as against malaria, leading reduction other measures delay seeking. Initial resistance related more than per se, but rejection acceptance were embedded complex constellation local wider contextual factors. Conclusions  together accepted after rejection. The factors that led this largely related, they resonate much cultural themes (rumours about research health interventions, gender inequality health-related decision making). prior administration played key role community. However, studies, different social settings using drugs regimens, are needed before generalizations can be made. Although from actual implementation, it is necessary acceptability implementation order anticipate problems design information campaigns ensure maximum acceptance. Keywords  malaria , Mozambique rumours Objectifs  Decrire les par rapport au Programme d'Immunisation Etendue (PIE) et Traitement Preventif Intermittent (TPI) administres aux jeunes enfants ainsi que des rapports entre ces deux systemes. Plus particulierement, de savoir d'une part si l'introduction du TPI chez affecte negativement la communaute face PIE son utilisation d'autre si, comment, delivrance simultanee l'immunisation influencent sur le TPI. Methodes  Une etude anthropologique ete menee dans cadre d'un essai avec sulfadoxine-pyrimethamine administree en meme temps vaccinations sous PIE. Nous avons utilise profondes ouvertes, semi structurees l'observation participants, menees fois niveau cliniques. Resultats  Le etait generalement acceptable malgre une reticence prealable. Les negatifs percus n'ont pas et, n'a mal interprete comme etant immunisation contre conduisant autres mesures prevention ou retarder recours traitement. La initiale plus liee l'essai qu'au enfants, mais rejet tout l'acceptation faisait partie complexe facteurs locaux provenant contexte large. Conclusions  administre accepte apres un initial. lies ce etaient surtout associes clinique elle-meme, ils aussi culturaux larges (rumeurs recherche interventions sante, inegalites sexes prise sante). L'acceptation l'administration prealables joue cle pour communauteetudiee. Cependant, etudes supplementaires differents niveaux sociaux d'autres medicaments regimes sont necessaires avant qu'une generalisation ne soit possible. Bien sites d'essai soient d'implementation, il est necessaire d’etudier l'acceptabilite l'implementation afin d'anticiper problemes concevoir campagnes d'information qui assurent communaute. Mots cles  acceptabilite, rumeurs Objetivo  Describir las actitudes frente al PAI y IPTi, percepciones sobre relacion ambos. En introduccion del afecta forma negativa comunitarias o el uso PAI; contraria entrega simultanea inmunizaciones tiene influencia percepcion IPTi. Metodos  Estudio antropologico llevado cabo dentro contexto ensayo con sulfadoxina-pirimetamina entregada junto vacunaciones rutinarias PAI. Utilizamos entrevistas profundidad, semi-estructuradas observacion participativa, fueron conducidas tanto comunidad como entorno los centros sanitarios. Resultados  general fue aceptado, pesar una resistencia inicial. Los aspectos negativos percibidos no afectaron PAI, interpretado inmunizacion conllevase reduccion otras medidas preventivas retrasase busqueda tratamiento. inicial estaba mas relacionada clinico pero rechazo aceptacion estaban encajadas mundo complejo factores locales amplio. Conclusiones  El entregado aceptado tras llevaron dicho eran principalmente caracter relacionados clinico, aunque tambien resonaban temas culturales amplios (rumores investigacion intervenciones salud, inequidad genero toma decisiones relacionadas salud). previa administracion rutinaria jugo papel clave esta comunidad. Sin embargo, antes se pueda generalizar, requieren estudios diferentes contextos sociales asi utilizando otros medicamentos regimenes. Aunque disposicion ensayos clinicos es diferente implementacion real, necesario estudiar aceptabilidad fin anticiparse problemas disenar campanas informacion para asegurar maxima comunitaria. Palabras clave  rumores

参考文章(21)
J Brown, K Murphy, D Heymann, G Kesseng, P Djogdom, Identifying the reasons for low immunization coverage. A case study of Yaounde (United Republic of Cameroon). Revue D Epidemiologie Et De Sante Publique. ,vol. 30, pp. 35- 47 ,(1982)
Barney G. Glaser, The Discovery of Grounded Theory ,(1967)
Mary Eming Young, Investing in Young Children ,(1995)
Alan D. Lopez, Reducing child mortality Bulletin of The World Health Organization. ,vol. 78, pp. 1173- 1173 ,(2000) , 10.1590/S0042-96862000001000002
G Pison, A Desgrées du Loû, Barriers to universal child immunization in rural Senegal 5 years after the accelerated Expanded Programme on Immunization. Bulletin of The World Health Organization. ,vol. 72, pp. 751- 759 ,(1994)
Jeannine Coreil, Antoine Augustin, Neal A. Halsey, Elizabeth Holt, Social and psychological costs of preventive child health services in Haiti. Social Science & Medicine. ,vol. 38, pp. 231- 238 ,(1994) , 10.1016/0277-9536(94)90393-X
Francisco Saute, Clara Menendez, Alfredo Mayor, John Aponte, Xavier Gomez-Olive, Martinho Dgedge, Pedro Alonso, Malaria in pregnancy in rural Mozambique: the role of parity, submicroscopic and multiple Plasmodium falciparum infections Tropical Medicine & International Health. ,vol. 7, pp. 19- 28 ,(2002) , 10.1046/J.1365-3156.2002.00831.X
Mike Poltorak, Melissa Leach, James Fairhead, Jackie Cassell, ‘MMR talk’ and vaccination choices: An ethnographic study in Brighton Social Science & Medicine. ,vol. 61, pp. 709- 719 ,(2005) , 10.1016/J.SOCSCIMED.2004.12.014