Research

Social and cultural aspects of 'malaria' and its control in central Côte d'Ivoire

Clémence Essé^1,2 , Jürg Utzinger³ , Andres B Tschannen² , Giovanna Raso^4,5 , Constanze Pfeiffer³ , Stefanie Granado³ , Benjamin G Koudou^2,6 , Eliézer K N'Goran^2,6 , Guéladio Cissé² , Olivier Girardin⁷ , Marcel Tanner³ and Brigit Obrist³

¹  Institut d'Ethno Sociologie, Université de Cocody-Abidjan, 01 BP V34, Abidjan 01, Côte d'Ivoire

²  Centre Suisse de Recherches Scientifiques, 01 BP 1303, Abidjan 01, Côte d'Ivoire

³  Department of Public Health and Epidemiology, Swiss Tropical Institute, P.O. Box, CH-4002, Basel, Switzerland

⁴  Division of Epidemiology and Social Medicine, School of Population Health, University of Queensland, Herston Road, Brisbane, QLD 4006, Australia

⁵  Molecular Parasitology Laboratory, Queensland Institute of Medical Research, 300 Herston Road, Brisbane, QLD 4006, Australia

⁶  Unité de Formation et de Recherche des Biosciences, Université de Cocody-Abidjan, 22 BP 770, Abidjan 22, Côte d'Ivoire

⁷  Fondation Rurale Interjurassienne, Courtemelon, P.O. Box 65, 2852 Courtételle, Switzerland

author email corresponding author email

Malaria Journal 2008, 7:224doi:10.1186/1475-2875-7-224

Published:	30 October 2008

Abstract

Background

A sound local understanding of preventive measures and health-seeking behaviour is important for the effective control of malaria. The purpose of this study was to assess the knowledge, attitudes, practices and beliefs of 'malaria' and its control in two rural communities of central Côte d'Ivoire, and to examine associations between 'malaria' and the households' socioeconomic status.

Methods

A cross-sectional household survey was carried out, using a combination of qualitative and quantitative methods. People's socioeconomic status was estimated, employing a household asset-based approach.

Results

Malaria was identified as djèkouadjo, the local folk name of the disease. Although people were aware of malaria-related symptoms and their association with mosquitoes, folk perceptions were common. In terms of treatment, a wide array of modern and traditional remedies was employed, often in combination. Individuals with a sound knowledge of the causes and symptoms of malaria continued to use traditional treatments and only a few people sleep under bed nets, whereas folk beliefs did not necessarily translate into refusal of modern treatments. Perceived causes of malaria were linked to the household's socioeconomic status with wealthier individuals reporting mosquitoes more frequently than poorer households. Bed nets were more frequently used in wealthier social strata, whereas other protective measures – perceived to be cheaper – were more prominent among the poorest.

Conclusion

Equitable access to resources at household, community and health system levels are essential in order to enable community members to prevent and treat malaria. There is a need for community-based approaches that match health care services with poor people's needs and resources.