title: Distinguishing social and cultural features of cholera in urban and rural areas of Western Kenya: Implications for public health.
abstract: Urban and rural areas have distinctive health problems, which require consideration. To examine sociocultural features of cholera and its community context, a semi-structured explanatory model interview based on vignettes depicting typical clinical features of cholera was used to interview 379 urban and rural respondents in Western Kenya. Findings included common and distinctive urban and rural ideas about cholera, and its prevention and treatment. The three most commonly perceived causes among urban and rural respondents collectively were drinking contaminated water, living in a dirty environment and lacking latrines. However, a dirty environment and flies were more prominently perceived causes among urban respondents. Rural respondents were less likely to identify additional symptoms and more likely to identify biomedically irrelevant perceived causes of cholera. Oral rehydration therapy was the most frequently reported home treatment. Health facilities were recommended unanimously at both sites. For prevention, rural respondents were more likely to suggest medicines, and urban respondents were more likely to suggest health education and clean food. Findings indicate community priority, demand for and potential effectiveness of enhanced efforts to control cholera in Western Kenya, and they suggest strategies that are particularly well suited for control of cholera in urban and rural areas.
authors.affiliation: Department of Sociology and Anthropology, Maseno University, Maseno, Kenya. erick.nyambedha@gmail.com
authors.forename: Erick Otieno
authors.initials: EO
authors.lastname: Nyambedha
authors.forename: Neisha
authors.initials: N
authors.lastname: Sundaram
authors.forename: Christian
authors.initials: C
authors.lastname: Schaetti
authors.forename: Lilian
authors.initials: L
authors.lastname: Akeyo
authors.forename: Claire-Lise
authors.initials: CL
authors.lastname: Chaignat
authors.forename: Raymond
authors.initials: R
authors.lastname: Hutubessy
authors.forename: Mitchell G
authors.initials: MG
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D002771:Cholera / Q000517:prevention & control* / Q000523:psychology; D003430:Cross-Sectional Studies; D003469:Culture; D005260:Female; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011634:Public Health; D012424:Rural Population; D012648:Self Care / Q000706:statistics & numerical data; D012919:Social Behavior; D014505:Urban Population; D035862:Vulnerable Populations; D055815:Young Adult