The social burden of malaria: what are we measuring?

Definitions of the burden of malaria vary by public health discipline. Epidemiologists and economists commonly use a quantitative approach to measure risk factors and associate them with disease outcomes. In contrast, since burden is itself a cultural construct, an anthropologic perspective of the burden of disease considers the sociocultural context in which these risk factors exist. This broader concept of burden is rarely tackled, most likely stemming from a lack of understanding of what is meant by the term social burden. This report describes the concept from an anthropologic perspective. The aim is to provide a better understanding of the process through which social and cultural factors affect the biomedical burden of malaria. The consequences of adopting this perspective for public health in general and malaria interventions in particular are discussed.