Recognition and action towards meningitis amongst patients, their families and health providers in Blantyre, Malawi
Dr Macpherson Mallewa, Dr Nicola Desmond, Prof David Lalloo, Prof Elizabeth Molyneux, Prof Robert Heyderman
- Start Date:
01 November 2012
Liverpool School of Tropical Medicine, Liverpool, UK
Acute bacterial meningitis (ABM) in sub-Saharan African (SSA) countries such as Malawi is associated with unacceptably high rates of death and disability. Patients frequently present late in the disease, often receiving antibiotic treatment without definite diagnosis. In industrialised countries, patient advocacy groups (e.g. MRF) in partnership with community and hospital-based healthcare workers have been highly successful in improving early disease recognition and access to definitive treatment. In contrast, in African communities little is known about how treatment seeking decisions are made for ABM and the community barriers to treatment have not been defined.
This study will use qualitative techniques to identify the decisions people and providers make when faced with the symptoms of ABM within the household, community and at different stages of the health seeking process. Specifically we will outline the barriers and facilitators for treatment seeking amongst those who reach hospital services in urban Blantyre, Malawi. We will also explore lay understandings and interpretations of the symptoms of ABM in the context of a broader socio-cultural framework and determine the effect of social environment on the recognition of disease severity and willingness or ability to take action.
The results of this study will inform the design of community based interventions to improve early recognition and prompt treatment of ABM amongst both adults and children in Malawi. A comprehensive description of the complexity of factors that affect health seeking behaviour for ABM will also inform the management of acute febrile illness in general (a very common phenomenon in SSA).
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