Perception of risk for malaria and schistosomiasis in rural Malawi

A sample of 120 individuals--representative of the Malawian population in terms of gender and age distribution--were interviewed regarding their perceptions of the diseases malaria and schistosomiasis. Particular attention was paid to judgements regarding the level, seriousness, predictability and controllability of these health risks. Sample sites were lowland marshland areas where both diseases were highly prevalent. Individuals were also asked about their adherence to recommended malaria and schistosomiasis control and prevention procedures. Respondents commonly rated malaria and schistosomiasis both unpredictable and uncontrollable. For malaria, no risk judgements predicted level of adherence to prevention guidelines. That is, individuals' perception of malaria risk bore no influence on whether or not they engaged in recommended behaviour. For schistosomiasis, seriousness of infection (at one sample site) and the predictability and controllability of infection (at the other sample site) predicted such adherence. Analysis of the influence of factors such as age, gender and level of education confirmed distinct patterning or responses for the two health risks. Whilst adherence to preventative guidelines for schistosomiasis is influenced by personal perceptions of risk, it appears that social factors may exert more influence on the extent of compliance with malaria control and prevention procedures. Distinct approaches to health education regarding malaria and schistosomiasis may, therefore, be warranted, with the former emphasising community responsibility and participation, and the latter individual actions which may reduce risk.