Epidemiology, anthropology and health education

Abstract

Epidemiology gives only a partial picture of a health problem. Without a knowledge of social, cultural, and economic conditions as well, one can fall into farcical errors in designing interventions.

PIP: A large dam was built on the Benoue River in the north of Cameroon in 1982, creating a reservoir of over 500 km. The health care system could no longer meet day-to-day needs. The principles of schistosomiasis control are simple. However, implementing them raises a lot of problems. In 1986, an epidemiological survey was carried out, covering 15 villages of about 1000 people chosen at random. At the same time, a socio anthropological study was done in certain representative villages. Interviews were conducted to gather information on perceptions of health, disease, socio cultural structures, and the extent to which the natives understood the educational imagery that was used. Excreters of schistosoma eggs were detected. Overall prevalence rates were 25% for urinary schistosomiasis, and 15% for Mason's intestinal schistosomiasis, with ranges of 7-35% and 7-29%, respectively. 70% of the egg excreters were under 20 years old. 3 high prevalence villages were large in size and had primitive sanitation. Patients can be treated with praziquantel, which is effective against Schistosoma, hematobium and Schistosoma mansoni. Good environmental surveillance and a good sanitation system are necessary. From the anthropological survey, information was gathered so that a community-centered system for monitoring and preventing schistosomiasis might be established. A number of different tribes are represented, and the nature of settlements is transitory. The villagers usually said that schistosomiasis came from the drinking of lake water or sexual intercourse. Most groups urinate or defecate away from built-up areas. Illness was usually linked with pain. 2 types of treatment are available for schistosomiasis. The 1st is traditional, the 2nd involves attending a health center. The schistosomiasis parasite cycle was not well understood by many villagers, revealing the need for simple educational messages.