title: Social and cultural aspects of 'malaria' and its control in central Côte d'Ivoire.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institut d'Ethno Sociologie, Université de Cocody-Abidjan, 01 BP V34, Abidjan 01, Côte d'Ivoire. clemence.esse@csrs.ci
authors.forename: Clémence
authors.initials: C
authors.lastname: Essé
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: Andres B
authors.initials: AB
authors.lastname: Tschannen
authors.forename: Giovanna
authors.initials: G
authors.lastname: Raso
authors.forename: Constanze
authors.initials: C
authors.lastname: Pfeiffer
authors.forename: Stefanie
authors.initials: S
authors.lastname: Granado
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Koudou
authors.forename: Eliézer K
authors.initials: EK
authors.lastname: N'Goran
authors.forename: Guéladio
authors.initials: G
authors.lastname: Cissé
authors.forename: Olivier
authors.initials: O
authors.lastname: Girardin
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Brigit
authors.initials: B
authors.lastname: Obrist
mesh_terms: D000293:Adolescent; D000328:Adult; D007560:Cote d'Ivoire / Q000453:epidemiology / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000208:ethnology* / Q000517:prevention & control / Q000628:therapy; D008297:Male; D016488:Medicine, African Traditional; D012307:Risk Factors; D012923:Social Class; D055815:Young Adult