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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.
Received August 21, 2003. Accepted for publication January 8, 2004.
Acknowledgments: We acknowledge the support of the Department for International Development Malaria Knowledge Program at the London School of Hygiene and Tropical Medicine, the Malaria Branch of the Centers for Disease Control and Prevention (in particular Dr. Peter B. Bloland for his helpful comments), and the Partnership for Social Sciences in Malaria Control.
Authors addresses: Caroline O. H. Jones, Department of Infectious and Tropical Diseases/Disease Control and Vector Biology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Telephone: 44-20-7927-2649, Fax: 44-20-7580-9075, E-mail: caroline.jones{at}lshtm.ac.uk. Holly A. Williams, Malaria Epidemiology Branch, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway NE, Atlanta, GA 30341, Telephone: 770-488-7764, Fax: 770-488-7794, E-mail: hbw2{at}cdc.gov.
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