Soil transmitted Helminths : an ethnografic study of the community perspective, lay beliefs and practices in Ngombe, Zambia

Intestinal worm infections are prevalent in tropical and subtropical areas, and are, from a public health perspective, a significant cause of morbidity in many areas. Factors that contribute to spreading infections are inadequate sanitary facilities/water supplies, and lack of health care services. The aim of this study is to investigate how Soil Transmitted Helminth infections are being dealt with in Ngombe, a deprived area in Zambia. How do people dispose-off faecal matter in the community? How do lay people perceive worm infections, their symptoms and causes? What do lay people do to treat and prevent infections? To what extent are these infections considered as a health problem? This study is based on fieldwork, observations, and interviews with sixty-five informants, conducted from August to December 2001 in Ngombe, Zambia. Disposal of faecal matter varies according to age and availability of facilities: in children from using nappies, defecating on the ground, use of latrines to use of the bush; and use of latrines and the bush for adults. Lay beliefs about the cause of symptoms of intestinal worm infections vary: excessive consumption of particular vegetables, eating soil and contaminated food, eating vegetable which has been sprayed with pesticides, playing in contaminated soil and water, and finally, the condition may be perceived as congenital. While some people seek biomedical help, others distrust biomedical treatment and choose seeking traditional healers for treatment. However, many people think intestinal worm infections are natural , or no more than a minor health problem. This study demonstrates and argues that public health initiative needs to be based on local community needs, in order to take into account the material resources, various perceptions, ideas and explanatory frameworks people have in relation to worm infections