Local perceptions of dengue fever in northeast Thailand and their implications for adherence to prevention campaigns

Abstract

The government of Thailand has invested heavily in community-based dengue fever prevention campaigns, yet community participation has been inadequate to prevent transmission. This ethnographic study explored local understandings of dengue in rural northeast Thailand, and their implications for adherence to government-initiated prevention measures centred around mosquito control. While community members recognised the most severe manifestation of the disease – dengue haemorrhagic fever (DHF) – as life threatening, they were unaware of the existence of the milder form of dengue fever (DF) that makes up the majority of cases. Consequently, milder fevers were believed to be something other than dengue, such that dengue was perceived as a rare illness, hindering participation in prevention. Furthermore, a local illness category, khai mak mai (‘fruit fever’) complicated the diagnosis, treatment and prevention of dengue fever, as people viewed it as both difficult to distinguish from dengue, and untreatable by biomedicine.

Keywords:

• dengue fever
• disease prevention
• health education
• explanatory models
• Thailand

Acknowledgements

Thanks go out to the many people who gave their time to be interviewed or otherwise supported this project. In particular, thanks to Weeraform Phuangtum, Terdsak Phuangtum, Prakit Phromsakha, Tanida Saengpheng, Ratsamee Tongsai, Manop Kanato, and Daravone Kittiphanh. This research was also made possible by grants from the Social Sciences and Humanities Research Council of Canada (Award No. 752-97-0631), the US National Science Foundation (Grant No. 9816972), the Wenner-Gren Foundation for Anthropological Research (Grant No. 453230), and the Department of Anthropology (Riecker Grant) at the University of Arizona. Research was conducted in partial fulfillment of a doctorate degree in medical anthropology at the University of Arizona, under the supervision of Dr Mark Nichter. Ethics approval was granted by both the University of Arizona, USA, and the sponsoring institution, Khon Kaen University, Thailand.