Patterns of care for childhood malaria in Zambia.

Malaria is a major cause of death among children in many parts of the world, even though simple and effective treatments exist. This study examines care-seeking patterns and barriers to appropriate treatment for Zambian children with fever or convulsions, two key symptoms of malaria. The study focuses on community perceptions of and response to febrile illness, using illness narratives as the primary data collection vehicle. The 154 detailed narratives indicate that mothers recognize fever and treat promptly, and consider chloroquine in conjunction with anti-pyretics to be the appropriate treatment. Synchronic and diachronic analyses show that most treatment begins at home, although the majority of cases are also seen in the formal health system. However, whether treated at home or taken to the health center, most children do not receive appropriate care--in this case, a 3-day course of chloroquine--because of problems of access and lack of understanding of the importance of giving the full dose. Further, those children who continue to have fever despite receiving chloroquine seldom receive the recommended second-line treatment with sulfadoxine-pyrimethamine. Most children with symptoms of convulsions are taken to the health center, but are more likely than children with simple malaria to receive traditional treatments as well.

The effect of tailoring a model HIV prevention program for local adolescent target audiences.

In five U.S. sites (Nashville, Tennessee; Newark, New Jersey; northern Virginia; Phoenix, Arizona; and Sacramento, California), HIV risk-reduction workshops were mounted as a part of the Prevention Marketing Initiative (PMI). In four of the five sites, the workshop curriculum was a version of Be Proud! Be Responsible! (Jemmott, Jemmott, & McCaffree, 1996) that had been tailored to fit the needs of local target audiences. This article describes the evaluation of the PMI workshops. Protective effects on several behavioral determinants and behavioral outcome measures were observed 1 month after the workshops. Based on the overall pattern of results, it was concluded that the PMI workshops reduced the likelihood of unprotected sex among participants. The intervention developed by Jemmott and colleagues appears to have retained its effectiveness after it was tailored to meet perceived local needs.

The relationship of perceived risk to condom use: why results are inconsistent.

PIP: This paper examined the factors associated with the inconsistent relationship between perceived risk and condom use among young adults. In a review of previously conducted case studies, 24 out of 25 studies found a positive relationship with self-efficacy. In this study, 709 teenagers from Sacramento, California, completed a self-administered baseline survey. The results revealed that 68% use condoms during sexual intercourse. An analysis of perceived risk showed that 25% belong to the high-perceived-risk respondents, while 75% belong to the low-perceived-risk respondents. Findings from the study indicated that the perceived risk for HIV transmission was a cause and effect of condom use and other precautionary behavior. In addition, the direction of the association between perceived risk and the behavior reverses depending on how a respondent interprets the perceived risk measure. Furthermore, in the development of indicators that measures the desired construct, open-ended question must be considered particularly during the pre-testing phase to find out how respondents were interpreting the perceived risk question.^ieng