title: Inherent illnesses and attacks: an ethnographic study of interpretations of childhood Acute Respiratory Infections (ARIs) in Manhiça, southern Mozambique.
abstract: BACKGROUND
  Pneumonia is a leading cause of childhood hospitalisation and child mortality in Africa. This study explores local interpretations of Acute Respiratory Infections (ARIs), focusing on caretakers of children under five in the context of hospital care seeking.
  
  
  METHODS
  The study took place in Manhiça, southern Mozambique and used Focused Ethnographic Study tools (FES) including field exercises and interviews.
  
  
  RESULTS
  Understandings of terms used to describe ARIs differed between caretakers and hospital staff. Children's sicknesses that hospital staff diagnosed as ARIs were interpreted by caretakers as intermittent "attacks" of xifuva, a permanent, inherent and incurable chest illness. Caretakers thought that it was possible to manage and treat the attacks, which were caused by immediate natural factors such as food or the weather, but not the underlying illness, which was seen as having more indirect and social causes. Explanations of illness could not be neatly separated into pluralistic categories, but were characterised by syncretism, with "lay" and "biomedical" terms and concepts intermingling in practical care-seeking interactions between caretakers and health staff.
  
  
  CONCLUSIONS
  Health promotion should take into account the syncretism involved in explanations of ARIs in the context of practical care seeking for children. In doing so, it should draw upon lay interpretations and terminologies in order to stress the importance of seeking hospital care for all xifuva-type illnesses as well as seeking care for any subsequent attacks of an already diagnosed xifuva. However, this should be undertaken with awareness that the meanings of the terms used in practical care-seeking interactions may change over time. Health communication about ARIs should therefore be ongoing and evidence-based, even if ARIs appear to be well understood.
authors.affiliation: Barcelona Centre for International Health Research, Hospital Clinic/Institut d'Investigacions Biomediques, University of Barcelona, Rosselló 132, 08036 Barcelona, Spain.
authors.forename: Lianne
authors.initials: L
authors.lastname: Straus
authors.forename: Khátia
authors.initials: K
authors.lastname: Munguambe
authors.forename: Quique
authors.initials: Q
authors.lastname: Bassat
authors.forename: Sonia
authors.initials: S
authors.lastname: Machevo
authors.forename: Christopher
authors.initials: C
authors.lastname: Pell
authors.forename: Anna
authors.initials: A
authors.lastname: Roca
authors.forename: Robert
authors.initials: R
authors.lastname: Pool
mesh_terms: D000884:Anthropology, Cultural; D017028:Caregivers; D002669:Child Welfare; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D009073:Mozambique; D012141:Respiratory Tract Infections / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D020377:Self Efficacy