Cargando…
The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia
BACKGROUND: Clinical trials require high levels of participation and low drop-out rates to be successful. However, collecting blood samples from individuals recruited into clinical trials can be challenging when there is reticence about blood-taking. In addition to concerns regarding the feasibility...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985146/ https://www.ncbi.nlm.nih.gov/pubmed/27525652 http://dx.doi.org/10.1371/journal.pone.0160464 |
_version_ | 1782448021328363520 |
---|---|
author | O’Neill, Sarah Dierickx, Susan Okebe, Joseph Dabira, Edgard Gryseels, Charlotte d’Alessandro, Umberto Peeters Grietens, Koen |
author_facet | O’Neill, Sarah Dierickx, Susan Okebe, Joseph Dabira, Edgard Gryseels, Charlotte d’Alessandro, Umberto Peeters Grietens, Koen |
author_sort | O’Neill, Sarah |
collection | PubMed |
description | BACKGROUND: Clinical trials require high levels of participation and low drop-out rates to be successful. However, collecting blood samples from individuals recruited into clinical trials can be challenging when there is reticence about blood-taking. In addition to concerns regarding the feasibility of medical research, fears of ‘blood-stealing’ and ‘blood-selling’ have ethical implications related to cultural sensitivity and informed consent. This study explores anxieties around blood-taking during a malaria treatment trial in the Gambia. METHODS: This case study is based on ethnographic research in one theoretically selected village due to the high reticence to screening for the clinical trial ‘Primaquine's gametocytocidal efficacy in malaria asymptomatic carriers treated with dihydroartemisinin-piperaquine’ carried out in the Gambia between 2013 and 2014. Data collection tools included in-depth interviews, participant observation, informal conversations and group discussions. RESULTS: In total only 176 of 411 habitants (42%) in the village accepted having a bloodspot taken to screen for malaria. Although trial recruitment was initially high in the village, some families refused screening when rumours started spreading that the trial team was taking too much blood. Concerns about ‘loss of blood’ were equated to loss of strength and lack of good food to replenish bodily forces. Families in the study village were concerned about the weakness of their body while they had to harvest their crops at the time of recruitment for the trial. CONCLUSION: A common recommendation to prevent and avoid rumours against public health interventions and trials is the provision of full and consistent information during the consent procedure, which is assumed to lead to more accurate knowledge of the purpose of the intervention and increased trial participation. However, even when information provision is continuous, the emergence of rumours can be related to times of uncertainty and perceptions of vulnerability, which are often a reflection of structural inequalities and diverging value orientations between communities and public health institutions. |
format | Online Article Text |
id | pubmed-4985146 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-49851462016-08-29 The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia O’Neill, Sarah Dierickx, Susan Okebe, Joseph Dabira, Edgard Gryseels, Charlotte d’Alessandro, Umberto Peeters Grietens, Koen PLoS One Research Article BACKGROUND: Clinical trials require high levels of participation and low drop-out rates to be successful. However, collecting blood samples from individuals recruited into clinical trials can be challenging when there is reticence about blood-taking. In addition to concerns regarding the feasibility of medical research, fears of ‘blood-stealing’ and ‘blood-selling’ have ethical implications related to cultural sensitivity and informed consent. This study explores anxieties around blood-taking during a malaria treatment trial in the Gambia. METHODS: This case study is based on ethnographic research in one theoretically selected village due to the high reticence to screening for the clinical trial ‘Primaquine's gametocytocidal efficacy in malaria asymptomatic carriers treated with dihydroartemisinin-piperaquine’ carried out in the Gambia between 2013 and 2014. Data collection tools included in-depth interviews, participant observation, informal conversations and group discussions. RESULTS: In total only 176 of 411 habitants (42%) in the village accepted having a bloodspot taken to screen for malaria. Although trial recruitment was initially high in the village, some families refused screening when rumours started spreading that the trial team was taking too much blood. Concerns about ‘loss of blood’ were equated to loss of strength and lack of good food to replenish bodily forces. Families in the study village were concerned about the weakness of their body while they had to harvest their crops at the time of recruitment for the trial. CONCLUSION: A common recommendation to prevent and avoid rumours against public health interventions and trials is the provision of full and consistent information during the consent procedure, which is assumed to lead to more accurate knowledge of the purpose of the intervention and increased trial participation. However, even when information provision is continuous, the emergence of rumours can be related to times of uncertainty and perceptions of vulnerability, which are often a reflection of structural inequalities and diverging value orientations between communities and public health institutions. Public Library of Science 2016-08-15 /pmc/articles/PMC4985146/ /pubmed/27525652 http://dx.doi.org/10.1371/journal.pone.0160464 Text en © 2016 O’Neill et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article O’Neill, Sarah Dierickx, Susan Okebe, Joseph Dabira, Edgard Gryseels, Charlotte d’Alessandro, Umberto Peeters Grietens, Koen The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia |
title | The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia |
title_full | The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia |
title_fullStr | The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia |
title_full_unstemmed | The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia |
title_short | The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia |
title_sort | importance of blood is infinite: conceptions of blood as life force, rumours and fear of trial participation in a fulani village in rural gambia |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985146/ https://www.ncbi.nlm.nih.gov/pubmed/27525652 http://dx.doi.org/10.1371/journal.pone.0160464 |
work_keys_str_mv | AT oneillsarah theimportanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT dierickxsusan theimportanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT okebejoseph theimportanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT dabiraedgard theimportanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT gryseelscharlotte theimportanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT dalessandroumberto theimportanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT peetersgrietenskoen theimportanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT oneillsarah importanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT dierickxsusan importanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT okebejoseph importanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT dabiraedgard importanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT gryseelscharlotte importanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT dalessandroumberto importanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia AT peetersgrietenskoen importanceofbloodisinfiniteconceptionsofbloodaslifeforcerumoursandfearoftrialparticipationinafulanivillageinruralgambia |