The authors declare that they have no competing interests.
BI, LG, and SHB are responsible for planning and study design. BI, LG, SHB, and AM participated in the data collection, the data analyses and the writing of the article. All authors read and approved the final manuscript.
This article discusses the link between disability and malaria in a poor rural setting. Global malaria programmes and rehabilitation programmes are organized as vertical and separate programmes, and as such they focus on prevention, cure and control, and disability respectively. When looking at specific conditions and illnesses, the impairing long-term consequences of illness incidents during childhood are not questioned.
The study design was ethnographic with an open, exploratory approach. Data were collected in Mangochi District in Malawi through qualitative in-depth interviews and participant observation.
Despite a local-based health service system, people living in poor rural areas are confronted with a multitude of barriers when accessing malaria prevention and treatment. Lack of skilled health personnel and equipment add to the general burden of poverty: insufficient knowledge about health care, problems connected to accessing the health facility in time, insufficient initiatives to prevent malaria attacks, and a general lack of attention to the long term disabling effects of a malaria attack.
This study points to the importance of building malaria programmes, research and statistics that take into consideration the consequences of permanent impairment after a malaria attack, as well as the context of poverty in which they often occur. In order to do so, one needs to develop methods for detecting people whose disabilities are a direct result of not having received health services after a malaria episode. This may be done through qualitative approaches in local communities and should also be supplemented by suitable surveys in order to estimate the problem on a larger scale.
Malaria Countries and Map: Malaria.com. 2011, [ http://www.malaria.com/info/malaria-countries-map.php]
New WHO malaria treatment guidelines stress need for diagnosis. 2010, Accessed March 10th 2011, [ http://apps.who.int/tdr/svc/news-events/news/malaria-guidelines]
World Health Organization: World Malaria Report. 2010, [Cited May 2011], [ http://www.who.int/malaria/world_malaria_report_2010/en/index.html] Geneva
Kreusch GT, Kilama WL, Moon S, Szlezák NA, Michaud CM: The global health system: linking knowledge with action - learning from malaria. PLoS Med. 2010, 7: 1-5. E1000179
Yeka A, Gasasira A, Mpimbaza A, Achtan J, Nankabirwa J, Nsobya S, Staedke SG, Donnelly MJ, Wabvire-Mangen F, Talisuna A, Dorsey G, Kamya MR, Rosenthal PJ: Malaria in Uganda: challenges to control on the road to elimination I. Epidemiology and current control efforts. Acta Trop. 2011, doi:10.1016/j.actatropica.2011.03.004
Idro R, Kakooza-Mwesige A, Balyejjussa S, Mirembe G, Mugasha C, Tugumisirize J, Byarugaba J: Severe neurological sequela and behaviour problems after cerebral malaria in Ugandan children. BMC Research Notes. 2010, 3: 104-10.1186/1756-0500-3-104. [ http://www.biomedcentral.com/1756-0500/3/104] PubMedCentralCrossRefPubMed
Murphy SC, Breman JG: Gaps in childhood malaria burden in Africa: cerebral malaria, neurological sequelae, anemia, respiratory distress, hypoglycemia, and complications of pregnancy. AmJTrop Med Hyg. 2001, 64: 57-67.
Brewster DR, Kwiatlowski D, White NJ: Neurological sequela of cerebral malaria in children. Lancet. 1990, 27: 1039-1043. CrossRef
Lewthwaite P, Begum A, How Ooi M, Farahger B, Foo Lai B, Sandaradura I, Mohan A, Mandan G, Meharwade P, Subhashini S, Abhishek G, Begum A, Penkulinti S, Veera Shankar M, Ravikumar R, Young C, Cardosa MJ, Ravi V, Chang Wong S, Kneen R, Solomon T: Disability after encephalitis: development and validation of a new outcome score. Bull World Health Organ. 2010, 88: 584-592. 10.2471/BLT.09.071357. PubMedCentralCrossRefPubMed
Birbeck GL, Molyneux ME, Kaplan PW, Seydel KB, Chimalizeni YF, Kawanza K, Taylor TE: Blantyre Malaria Project Epilepsy Study (BMPES) of neurological outcomes in retinopathy-positive paediatric cerebral malaria survivors: a prospective cohort study. Lancet Neurol. 2010, 9: 1173-1181. 10.1016/S1474-4422(10)70270-2. PubMedCentralCrossRefPubMed
Cromwell E, Kyegombe N: Food security options in Malawi: good neighbours make good friends?. Country Food Security Options Paper. 2005, Forum for Food Security in Southern Africa, 2-[ http://www.odi.org.uk/food-security-forum]
National Statistical Office of Malawi: The Welfare monitoring survey (WMS) 2009. 22-[ http://data.worldbank.org/indicator/AG.PRD.FOOD.XD]
Chinsinga B: The participatory development approach under a microscope: the case of poverty alleviation programme in Malawi. J Soc Dev Afr. 2003, 18: 129-143.
Malawi National Malaria Indicator Survey 2010. Lilongwe: Ministry of Health, Malawi. Malariasurveys.org, [ http://data.worldbank.org/indicator/AG.PRD.FOOD.XD]
Farmer P: An anthropology of structural violence. Curr Anthropol. 2004, 45: 305-325. 10.1086/382250. CrossRef
Yeo R, More K: Including disabled people in poverty reduction work: "Nothing about us, without us". World Dev. 2003, 31: 571-590. 10.1016/S0305-750X(02)00218-8. CrossRef
Grimen H, Ingstad B: Qualitative research. Research methodology in the medical and biological sciences. Edited by: Laake P, Benestad HB, Olsen BR. 2007, Oxford: Elsevier Ltd, 311-350.
Taylor S: A Reader. Ethnographic Research. 2002, London: SAGE Publications
Biernackiel P, Waldorf D: Snowball Sampling: Problems and Techniques of Chain Referral Sampling. Sociological Methods & Research. 1981, 10: 141-163. doi: 10.1177/004912418101000205 [Cited November 2011]
Dhingra N, Jha P, Sharma VP, Cohen AA, Jotkar RM, Rodriques PS, Bassani DG, Suraweera W, Laxminarayan R, Peto R: Adult and child malaria mortality in India: a nationally representative mortality survey. Lancet. 2010, 376: 1768-1774. 10.1016/S0140-6736(10)60831-8. [ http://dx.doi.org/10.1016/S0140-6736(10)60831-8] PubMedCentralCrossRefPubMed
Ribera JM, Hausmann-Muela S: The Straw That Breaks the Camel's Back. Med Anthropology Q. 2011, 25: 103-121. 10.1111/j.1548-1387.2010.01139.x. CrossRef
Maslove DM, Mnyusiwalla A, Mills EJ, McGowan J, Attran A, Wilson K: Barriers to the effective treatment and prevention of malaria in Africa: A systematic review of qualitative studies. BMC Int Health Human Rights. 2009, 9: 26-10.1186/1472-698X-9-26. doi10.1186/1472698x-9-26 CrossRef
Farmer P: Pathologies of power. Health, human rights and the new war on the poor. 2003, Berkeley, CA: University of California Press
Kleinman A: The violence of everyday life: the multiple forms and dynamics of social violence. Violence and subjectivity. Edited by: Daas V, Kleinman A, Ramphele M, Reynolds P. 2000, Berkeley, CA: University of California press, 226-41.
- The evil circle of poverty: a qualitative study of malaria and disability
Alister C Munthali
Stine H Braathen
- BioMed Central
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