Cultural and social context of dysentery: implications for the introduction of a new vaccine.

Dysentery, a severe form of diarrhoeal disease, is a major cause of morbidity and mortality. Paradoxically, virtually no studies have been conducted to examine beliefs and behaviours associated with dysentery. The explanatory model of dysentery was explored in a community in Dhaka, Bangladesh, to understand the acceptability of a vaccine against dysentery. A local term for bloody dysentery is widely known, and residents describe a progression of symptoms, which closely mirrors the biomedical model of the disease. Due to the symbolic significance of blood loss and the fact that there is much uncertainty regarding treatment, bloody dysentery is perceived to be extremely serious. Causal interpretations most commonly relate to humoral theories, and remedies involve the consumption of 'cooling' foods that will reduce the heat associated with dysentery. Despite many misconceptions about vaccines and the fact that this approach contradicts aetiological explanations, the perceived severity of the illness makes vaccines attractive compared to other preventative measures. The results illuminate relevant information for the implementation of a new vaccine.