Learning from local knowledge to improve disease surveillance: perceptions of the guinea worm illness experience

摘要: Surveillance is an essential tool in any campaign to eradicate disease; guinea worm (dracunculiasis), which targeted for eradication before the year 2000, no exception. One criterion of eradicable disease that it be easy recognize as program advances. Few experts doubt experience a meter-long subcutaneous protruding through painful ulcer can missed or confused with another disease, thus ensuring meets this criterion. Field experiences anthropologists and health educators have shown one should never assume community perceptions illness coincide fully medical case definitions disease. This paper describes efforts learn how Yoruba people southwestern Nigeria perceive sobia, local name worm. Qualitative methods including informal interview, village discussion participant observation were used discern pattern presentation progression. Interestingly, found include variety manifestations beyond common clinical definition emergent worm, creating potential high level false positive reports. Local knowledge was then design pilot project trained volunteers become part surveillance network national program. The volunteers, who largely illiterate, able distinguish between cultural definitions, submit quite accurate reports on status their villages. Among 164 only two submitted due incorrect definition. In contrast government workers conducting searches during same period significantly more likely register culturally sensitive training based received by thought contributed superior performance.