title: Culture and Dehydration: A Comparative Study of Caída de la Mollera (Fallen Fontanel) in Three Latino Populations.
abstract: A sunken soft-spot or fontanel is a sign for dehydration in infants. Around the world, folk illnesses, such as caída de la mollera in some Latin American cultures, often incorporate this sign as a hallmark of illness, but may or may not incorporate re-hydration therapies in treatment strategies. This report describes a study of lay descriptions of causes, symptoms, and treatments for caída de la mollera in three diverse Latin American populations. A mixed-methods approach was used. Representative community-based samples were interviewed in rural Guatemala, Guadalajara, Mexico, and Edinburgh, Texas, with a 132 item questionnaire on the causes, susceptibility, symptoms, and therapies for caída de la mollera. Cultural consensus analysis was used to estimate community beliefs about caída. Interviews conducted in rural Guatemala (n = 60), urban Mexico (n = 62), and rural Texas on the Mexican border (n = 61) indicated consistency in thematic elements within and among these three diverse communities. The high degree of consistency in the illness explanatory models indicated shared beliefs about caída de la mollera in each of the communities and a core model shared across communities. However, an important aspect of the community beliefs was that rehydration therapies were not widely endorsed. The consistency in explanatory models in such diverse communities, as well as the high degree of recognition and experience with this illness, may facilitate communication between community members, and health care providers/public health intervention planners to increase use of rehydration therapies for caída de la mollera. Recommendations for culturally informed and respectful approaches to clinical communication are provided.
authors.affiliation: Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA. Lpachter@drexelmed.edu.|Center for the Urban Child, Section of General Pediatrics, St. Christopher's Hospital for Children, 160 East Erie Ave, Philadelphia, PA, 19134, USA. Lpachter@drexelmed.edu.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Pachter
authors.affiliation: Department of Preventive Medicine and Community Health and Department of Family Medicine, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Weller
authors.affiliation: Department of Anthropology, University of South Florida, Tampa, FL, USA.
authors.forename: Roberta D
authors.initials: RD
authors.lastname: Baer
authors.affiliation: UIESS, IMSS, Guadalajara, Guadalajara, Mexico.
authors.forename: Javier E Garcia
authors.initials: JEG
authors.lastname: de Alba Garcia
authors.affiliation: University of Texas, Edinburg, TX, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Glazer
authors.affiliation: Department of Anthropology, Northern Arizona University, Flagstaff, AZ, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Trotter
authors.affiliation: Medical Entomology Research and Training Unit, Centers for Disease Control and Prevention (CDC), Guatemala City, Guatemala.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Klein
authors.affiliation: Department of Family Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Gonzalez
mesh_terms: D000328:Adult; D003681:Dehydration / Q000208:ethnology* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006166:Guatemala / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D007223:Infant; D008297:Male; D008519:Medicine, Traditional; D008800:Mexico / Q000453:epidemiology; D012424:Rural Population; D013781:Texas / Q000453:epidemiology; D014505:Urban Population
keywords: Culture; Dehydration; Ethnomedicine; Folk illness; Hispanic; Latino