LOCAL UNDERSTANDINGS OF ADULT DIARRHEAL DISEASE AND ITS TREATMENT IN AN AREA OF HIGH HIV-SEROPREVALENCE IN ZAMBIA

We set out to investigate the extent to which cultural constructs migh t determine treatment-seeking for diarrhoea in the poorer populations of Lusaka, Zambia. This paper describes these concepts and perceptions and outlines a classification of such illnesses, together with an ana lysis of its implications for understanding treatment choice. Data wer e derived from focus group discussions, a household survey, a survey o f practitioners of traditional medicine and interviews with local resi dents attending an urban health centre with persistent diarrhoea. The classification is based on symptoms and perceptions of aetiology. Whil e resulting categories convey imperatives for treatment choice, it is dear that individuals with diarrhoeal illnesses seek treatment from mu ltiple sources. This may be because any single illness may fit more th an one category, or because unrelenting ill-health engenders desperate behaviour. The cultural constructs do not fully explain treatment cho ice and attitudes to prevention, but could be used to improve communic ation regarding public health and treatment strategies.