sending the person described in the cholera vignette immediately to allopathic healthcare facilities, was considered as the least prominent category in the rural community, while it ranked fourth in the peri-urban community and was regarded as the most helpful thing one can selleck products do at home. The following statement from a housewife, aged 47 years, from Chumbuni is typical for what the communities would do for people with cholera at home: Table 5 Self treatment and help seeking for a cholera vignette in peri-urban and rural Zanzibar, n = 356 “At home we give water and other people give local treatment. [...] and if the condition becomes worse, we will send the patient to the hospital.” Public primary healthcare units and hospitals were mentioned by all respondents (Table (Table55 lower panel).

More than 95% of the peri-urban residents identified health facilities as most helpful source of treatment, while the rural residents’ preference was around 15% lower. Faith healers and traditional healers were of little importance and probing revealed that they would only be consulted after allopathic treatment had failed. Shigellosis versus cholera Similar to the cholera vignette, weakness was also rated as the most prominent somatic symptom for the shigellosis vignette (Table (Table66 top panel). Among symptoms related to dehydration, only loose skin and sunken eyes were mentioned; and both categories were reported significantly less for shigellosis than for cholera. The remaining symptoms of dehydration fell under the 5% threshold. All categories of somatic symptoms were differentiated on the individual level in both sites.

Table 6 Symptoms, perceived causes, and self treatment for a cholera and a shigellosis vignette in Zanzibar, n = 356 Notable among psycho-social problems was fear of infection and fear of isolation from others. Both categories were reported considerably less for shigellosis than for cholera, and were also well-differentiated (Table (Table66 second panel). All the other categories, which represent general features of diarrhoeal illness, i.e. costs, loss of family income, interference with social relationships and with daily activities, and being sad, anxious or worried, were not differentiated between both conditions (kappa coefficient greater than 0.4). A dirty environment was perceived to be the most prominent cause of shigellosis (Table (Table66 third panel).

The percentage of this category, however, was less than Drug_discovery half the percentage for cholera, and was closely followed by the category of eating unprotected or spoiled food. All categories of perceived causes that showed a significant difference between the two conditions were mentioned less frequently for shigellosis, with the exception of cannot say, which was reported three times more often for shigellosis than for cholera. Kappa coefficients for all categories were below the threshold of 0.4 suggesting differentiation of the meaning of cholera from shigellosis.