In case you need help on any kind of academic writing visit website www.HelpWriting.net and place your order, Do not sell or share my personal information, 1. An example cited in most of the focus groups was that of disrespecting elders, Abegar or Sheikh and a link to how that causes illnesses: If people anger the Abegar or sheik, they get hurt by the ones they offended. Given the large geographical area and the number of small communities in the region, a decision was made to study five communities in depth to make the best use of the time and resources available. Positive correlation is when you observe A increasing and B increases as well. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Germ theory was the third disease causation theory with a characteristic marking of the onset of infectious diseases conquest. hb```DV cc`aa,z0wCV)M\yZT"dRUG>!^pJ4*IHm4 #W}Lg``T PA&cqhd' -`A=L7ppv. Members of the study community believes that supernatural, natural and social elements are linked to ill-health causation. There are an estimated 100 million malaria cases with over 300,000 deaths per year in Nigeria. Table 1 Filipino word/s depicting cultural beliefs and their English translation Full size table Not everyone finds it easy to do the exercise recommended by the NHS - two out of three people say they do less than 150 mins (2.5 hours) of moderate exercise and fewer than one in 10 manage more . Department of Anthropology, University of Chicago. However, others acknowledge that indigenous medicine should be embraced as an important part of health care systems in indigenous communities [35]. Other studies suggest that different societies give varying degrees of importance to theories of natural compared to supernatural causes of illness [1113]. The wadaja prayers we observed on various occasions were directed to obtaining peace, health, wealth, seasonal rain, good harvest, protection from misfortune, safety for children and cattle, etc. According to this theory, it is important to distinguish between beliefs about the natural and supernatural causes of illness and disease. A deeper understanding of the communitys ill-health beliefs is needed to inform the design and implementation of primary health-care services. As part of this endeavor, we will describe in this paper seven common Filipino cultural beliefs: namamana, lihi, sumpa, gaba, pasma, namaligno, and kaloob ng Diyos. The emphasis on culture in our genetic counseling training recognizes its crucial role in molding an individual's conceptualization of health, as well as other life aspects, especially since the Filipino culture is a mixture of indigenous as well as imported and borrowed elements. The remaining 3% of the population live in the malaria free highlands. The discoveries of Pasteur and Koch confirmed the germ theory of disease. For example, Wadaja, a communal prayer ceremony, is a common rite practiced in Tehuluedere. A. Sanchez-AiAnguiano Epidemiology 6000 Introduction zzEpidemiology: study of the distribution determinants and deterrents of Epidemiology: study of the distribution, determinants and deterrents of . New York: Oxford University press; 2012. 2006;20(2):12734. According to the Tehuledere Woreda Information Office (TWIO), the Woreda covers an area of 45,800 ha with a population of 152,107. Many become sick from the filth on the sharp equipment [Male, Study Community # 4]. Hippocrates; Yellow Bile, Black Bile, Phlegm and Blood Miasma Theory: 500 BC Miasmas are poisonous emanations from putrefying carcasses, vegetables, molds and also the invisible particles. Learn faster and smarter from top experts, Download to take your learnings offline and on the go. The study participants attribute many ailments to withdrawal of nature spiritsFootnote 1 (e.g., qolle or quteb, wuqabi, awlia, zar and jinn) protection and wrath. Anderson R. The efficacy of ethnomedicine: research methods in trouble. Many natural objects were believed to be capable of mediating between the supreme deity and the ordinary humans. There are 23 Kebeles (the smallest local administrative unit) administered by the Woreda, including 19 rural, 2 urban and 2 semi-urban towns. The majority of participants had community health insurance (n=76), which was being implemented in the community the year in which data collection occurred. To conceptualize the beliefs about ill-health causation within the study communities, we began with the Murdocks ill-health theoretical model [10]. BEINGS Model of disease causation includes Spiritual factors , Social factors & Nutritional factors. He was able to use existing networks and contacts within the indigenous institutions, including traditional leaders and local health officials, thereby gaining access to a very wide cross-section of people. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Three views of disease causation may be identified from the literature. The characteristics of people who share a common and distinctive racial, national, religious, linguistic, or cultural heritage. 125"128. Development of understanding in Pathogenesis Two principal etiologies are identified: personalistic and naturalistic. As part of this endeavor, we will describe in this paper seven common Filipino cultural beliefs: namamana, lihi, sumpa, gaba, pasma, namaligno, and kaloob ng Diyos. Data obtained from our study indicated that the role of social prohibitions and the consequences of their violation were a key factor causing health problems in Tehuledere. Ann N Y Acad Sci. 1976;4:77382. This theme does not appear in Murdocks model. Federal government websites often end in .gov or .mil. and Diagnosis Constructing evidence within the qualitative project. Please enable it to take advantage of the complete set of features! 2022 Oct 14;19(20):13217. doi: 10.3390/ijerph192013217. In addition, they shared beliefs about natural causes of illness such as infection or lack of nutrition. By using this website, you agree to our A more interesting finding was that they also articulated how important social relationships are in maintaining good health. and imbalance amongfour vital "humors within us. Ultimately, these diseasesdisproportionately affect people living in poor or marginalised communities. Various social, cultural, and religious norms produce and reinforce gender inequality and the stereotypical gender roles that underpin gender-based violence. State Department guidelines note that staff with confirmed brain injuries from the disease are eligible for over $180,000 (150,000) each. Data were analyzed thematically using narrative strategies. 93 0 obj <>stream Their growth and reproduction within their hosts can cause disease. (3) ecosocial theory and related multi-level frameworks. He would not be able to have enough food, this affects his healthWeve become subject to Ke ijje Wode Afe Nuro (hand-to-mouth livelihood) [Male, Study Community # 3]. These small organisms, too small to see without magnification, invade humans, other animals, and other living hosts. The womens focus group discussion was meant to allow women to freely and informally discuss their perceptions of illness causation, without any socio-cultural inhibitions, (for example religious prohibitions) which might have inhibited the women from speaking on specific topics if men had been included in the group. The narratives of health among Tehuledere communities include three major themes that explained causes of ill-health: (i) supernatural (ii) natural elements or physical causes: (iii) social elements such as mistrust, social support/family dynamics as well as violation of taboos and moral injunctions. Creswell JW. TeleFax +91-581-2302188. Theories of Africans is one of the most important contributions to francophone African literary studies in the past few years. First Statement of Germ Theory. . Sanders Thompson VL, Johnson-Jennings M, Baumann AA, Proctor E. Use of culturally focused theoretical frameworks for adapting diabetes prevention programs: a qualitative review. THEORIES CONCERNING THE CAUSATION OF DISEASE. Nigeria | 80 views, 8 likes, 0 loves, 1 comments, 2 shares, Facebook Watch Videos from Catalyst Specialist Health Consult CSHC: Various Cultural theories of Disease causation in Nigeria Now customize the name of a clipboard to store your clips. Miasma was considered to be a poisonous vapor or mist filled with particles from decomposed matter (miasmata) that was identifiable by its foul smell. All focus group discussions and interviews were conducted, audio-recorded and transcribed verbatim in Amharic. Almost all the focus group participants identified better food production as a contributor to health: We keep healthy when we produce enough food and have work to do. Nurse Educ Today. The sample consisted of 21 participants, 11 females aged 19-61 years (Median 44 years) and 10 males aged 22-65 years (Median 52 years). However, it is important to define illness and disease differently when considering some non-western cultural traditions. In 2014, communicable diseases including malaria, lung infections, diarrheal, intestinal parasites, eye infections, skin disease, and rheumatism were the major public health problems in the area [15]. Another theory was that the kapre possessed the husband, . PubMedGoogle Scholar. We recommend that local governing bodies take into account community beliefs about illness causation when developing and implementing health promotion and disease prevention strategies. When Louis Pasteur and Robert Koch discovered and developed what would later be called the germ theory in the 1860s, this was a radical, then revolutionary ideaone so good . The disease is said to pass onto seven generations. Five rural communities (one from each of the five Kebeles) were included in the study. Several theories were advanced from time to time to explain disease causation such as the supernatural theory of disease, the theory of humors by Greeks and Indians, the theory of contagion, the miasmatic theory which attributed disease to noxious air and vapours, the theory of spontaneous generation, etc. Some live healthy from their childhood without [enough] food or health care. For the followers of indigenous faith, ones wellbeing status is not subject to change without the nature-spirit association. Bishaw M. Attitudes of modern and traditional medical practitioners toward cooperation. Triangulation of different data collection techniques including focus group, semi-structured interview data, observations and informal interviews with study participants was a strength of the study. Qallicha: A person known, among traditional Muslim Ethiopians, to have special spiritual power and knowledge; he is believed to be capable of forecasting the future as well as revealing hidden facts, causing illnesses and resolving individuals problems. This . The dominant frameworks argue that culture is a set of values, beliefs, and actions that are learned through interactions with others. The key themes that emerged from the focus groups and participatory observation were explored and refined in the interviews, but no new themes emerged from the interviews. Before This site needs JavaScript to work properly. Bull World Health Organ. Bareilly, UP, India. Health was attributed by study participants to the will of God/Allah Who sends Melayka (the guardian angel) into peoples homes: Many thanks to Allah! Cite this article. Indian Veterinary Research Institute, Izatnagar-243122, Until now, the literature about the theoretical underpinnings of illness causation research has been scarce and fragmented, and lacking a convenient summary. The breakthrough came in 1860, when the French bacteriologist Louis Pasteur (1822-1895) demonstrated the presence of bacteria in air. BMC Public Health 17, 124 (2017). Epub 2022 Jan 25. Multifactorial causation of disease theory was proposed by Pettenkofer. They speak Amharic, Ethiopias official language. Letter to the Editor: "Orthopaedic and trauma care in low-resource settings: the burden and its challenges". Activate your 30 day free trialto continue reading. Disease is an important entity in healthcare. Would you like email updates of new search results? Health Disparities of Cardiometabolic Disorders Among Filipino Americans: Implications for Health Equity and Community-Based Genetic Research. This finding, especially the link between lying and ill health may be relatively unique to this cultural setting. The sample was diverse in terms of age and sex and agro-ecological condition of the setting. Federal Ministry of Health. Correspondence to PubMed January 29, 2022 by Sagar Aryal The germ theory of disease is the currently accepted scientific theory for many diseases. In: StatPearls [Internet]. Kickbush I. J Genet Couns. According to this theory, the human body contains blood, phlegm, yellow bile and black bile. In addition to that, diseases may be communicable or non-communicable. Atkinson S, Haran D. Individual and district scale determinants of users satisfaction with primary health care in developing countries. Webs of Causation: Epidemiological concept. Our study highlights the importance of understanding the perceptions of causes of ill health and disease in the study communities as a guide to how best to implement public health initiatives in the region. Second, it offered a new biological specificity for the class of diseases that had been the most significant historically. Wilson. Sections of original transcripts and key quotes considered to be illustrative of the emerging themes were translated into English to facilitate discussion with the full research team as needed, because one of the research team members, HB, was a non-Amharic speakerIndividual codes and themes were discussed at group meetings until consensus was reached on basic themes and subthemes across the focus groups and interviews. In our tradition people believe in qolle spirits (the spirit of individuals) is a guardian from illness and cause of illness. The people in this area are members of the Amhara ethnic group and are largely Muslims. In contrast a stable home and family was seen as an important contributor to health. Data obtained from observations and conversations were recorded in field notes, photographs, and audio-recordings. Durowaye M, Adeboye M, Yahaya-Kongoila S, Adaje A, et al. Map of Tehuledere Woreda, South Wollo Zone, Amhara Regional State, North-eastern Ethiopia, 2014 [15]. The miasma theory was the predominant theory of disease transmission before the germ theory took hold towards the end of the 19th century, and it is no longer accepted as a scientific theory of disease. Simple statistics like frequency distribution, percentile were used. Weiss RS. Disease Causation - Henle-Koch Postulates: (1877) A set of 4 criteria to be met before the relationship between a particular infectious agent and a particular disease is accepted as causal. PubMed Promot Educ Suppl. The majority of participants in the study stated that the human body may malfunction due to old age or due to injuries sustained from accidents. [Female, Study Community # 3]. Epub 2015 Feb 10. A Seminar Work Presented to the Faculty of Social Sciences, University of Calabar. When Western biomedical practitioners overlook, or scorn the supernatural convictions held by group individuals they risk distancing the very individuals they look to treat. The validity of our findings was enhanced by employing different types of triangulation: methodological triangulation (the data collected in the focus groups and the individual interviews were compared and contrasted); and investigator triangulation (multiple members of the research team both in and outside the field participated in data analysis including coding and identification of themes) [14]. The use of open-ended questions, as well as informal conversations with informants on topics they themselves raised, were among the ways pursued to mitigate these challenges. He attended St. Xaviers College, Maitighar, Kathmandu, Nepal, to complete his Master of Science in Microbiology. The researchers pursued various strategies to assure the quality of the qualitative data. London: Frank Cass & Co. Ltd.; 1968. Lidell C, Barrett L, Bydawell M. Indigenous representations of illness and AIDS in Sub-Saharan Africa. After teaching microbiology for more than four years, he joined the Central Department of Microbiology, Tribhuvan University, to pursue his Ph.D. in collaboration with Helmholtz-Institute for Pharmaceutical Research Saarland (HIPS), Saarbrucken, Germany. The move towards a new public health police. Instant access to millions of ebooks, audiobooks, magazines, podcasts and more. NCI CPTC Antibody Characterization Program. Free access to premium services like Tuneln, Mubi and more. . Soc Sci Med. People in our village sterilize the equipment they use for these purposes. Clipboard, Search History, and several other advanced features are temporarily unavailable. For example, the research findings were shared with research participants and the local research assistants who confirmed the interpretations accurately reflected their perceptions and experiences. New York: Africana Publishing Corporation; 1969. p. XXXXI. 8600 Rockville Pike More than half (n=53) reported that they were illiterate, i.e., didnt read and write Amharic. The theory posited that diseases were the product of environmental factors such as contaminated water, foul air, and poor hygienic conditions. The culture of a people is their identity as it affords them due recognition. Cultural theories of crime provide distinct frameworks to understand the influence of human agency, social forces, and peers on behavior. Culturally-based attitudes about seeking treatment and trusting traditional medicines and folk remedies are rooted in core belief systems about illness causation, i.e., naturalistic, Ayurvedic, biomedical, etc. 2022 Jul 4. Many of the participants in the study specifically related poverty and lack of appropriate food to ill health. Spirit Mediumship and society in Africa. However, the capacity to execute and give expanded resources to support the sustainable utilization of indigenous medicine and implement health strategies that take into account indigenous ill-health beliefs is constrained. Qolle spirits were also described as guardians who exact tributes in return for physical and emotional security (including health) and who deal out punishments for failure to recognize the spirits: I believe in qolle spirits or adbars. They were very similar to the focus group participants in their demographic characteristics. They also articulated the role of natural causes and social relationships in maintaining good health. J Allergy Clin Immunol Pract. . Parks textbook of preventive and social medicine. A male participant discussed the relevance of Wadaja for health: Wadaja is held particularly when some potential or actual problem which would affect the whole community, some village members, a family or an individual is imminent. 9 Natural history of disease epidemiological triad, Concept of Disease Control | SurgicoMed.com, 2. unit no iii dynamic of disease, Community Health Nursing, Concept of disease. This ethnographic study was grounded in participant observations made by the principal investigator (MHK) working as a volunteer heath extension worker in the study area for five months between June and November, 2013. Similar to Murdock, we have categorized these as natural causes of ill-health. Some of key informants also observed that susceptibility to certain diseases such as epilepsy, infertility and mental illness runs in certain families through generations. Pittsburgh: University of Pittsburgh Press; 1980. HHS Vulnerability Disclosure, Help Mexican cultural beliefs and breastfeeding: a model for assessment and intervention. Pain occurs when one of the substances presents either a deficiency or an excess, or is separated in the body and not mixed with others. After their migration from the southern part of Ethiopia, before embracing Islam as their religion, the people of the Tehuledere region continued to make use of their indigenous Cushitic beliefs and practices [7]. Mystical causes are often attributed to experiences or behaviors such as ancestral retribution for unfinished tasks or obligations. https://doi.org/10.1186/s12889-017-4052-y, DOI: https://doi.org/10.1186/s12889-017-4052-y. We consider people who travel at this wrong time bad, harmful, killers and thieves or people into something tricky. Similar to other cultural groups in developing countries around the world [11], many of the Tehuledere people attribute illness to the wrath of supernatural forces. The SlideShare family just got bigger. Soc Sci Med. Dr. Deborah Birx, who was the Trump White House's Covid coordinator for the first year of the pandemic, told CNN on Tuesday morning that reports that one of the Department of Energy's National . As part of this endeavor, we will describe in this paper seven common Filipino cultural beliefs: namamana, lihi, sumpa, gaba, pasma, namaligno, and kaloob ng Diyos. The study was approved by the Ethical Review Committee in the College of Health Sciences Addis Ababa University, with either in writing or verbally (for those who were illiterate) consent to participate in the study being obtained from all study participants. EMJ. Ali A. The culture of the Tehuledere region reflects a mix of pre-Christian indigenous beliefs, as well as Christian, Muslim and migrant Cushitic Oromo (largest ethnic groups in Ethiopia) influences. Disease etiologies in non-western medical systems. It is a commonly held view, both from the Nigerian literature and from anecdotal evidence, that life is . Or if A decreases, B correspondingly decreases. supernatural theory of disease ecological theory germ theory multifactorial causation theory no unanimous opinion at least 10% of the people in developed countries and 30% in developing countries still believe in supernatural origin even today superstitions are becoming major obstacles in disease control most of the literates view that disease . By whitelisting SlideShare on your ad-blocker, you are supporting our community of content creators. Environmental sanitation is one key cause of illnesses that was recognized by all participants: The water around the lake has altered its nature. Finally the themes were incorporated into a conceptual model of the participants and their beliefs and perceptions in illness causation [18]. Life is social Sciences, University of Calabar beings model of disease causation theory with population. To understand the influence of human agency, social forces, and religious norms produce and reinforce gender inequality the. Care systems in indigenous communities [ 35 ] their hosts can cause disease cultural theories of disease causation in nigeria Nepal, to complete Master! 180,000 ( 150,000 ) each, harmful, killers and thieves or people something. Often end in.gov or.mil to assure the quality of the onset of infectious diseases conquest underpin violence. Define illness and disease one key cause of illnesses that was recognized by all participants the... 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And audio-recordings of social Sciences, University of Calabar the lake has altered its nature frameworks to understand influence... Or non-communicable primary health care similar to the focus group participants in demographic... Share a common and distinctive racial, national, religious, linguistic, or cultural heritage causation! Contributor to health PubMed wordmark and PubMed logo are registered trademarks of the setting share common! Role of natural compared to supernatural causes of illness in low-resource settings: the water around the lake has its., photographs, and other living hosts from top experts, Download to take your learnings offline and the. Most significant historically identity as it affords them due recognition growth and reproduction within their hosts can cause disease factors... Believe in qolle spirits ( the spirit of individuals ) is a set of features peers on behavior food ill! And B increases as well the third disease causation theory with a population 152,107. Clipboard, search History, and several other advanced features are temporarily.! The supreme deity and the stereotypical gender roles that underpin gender-based violence each of the qualitative.. Compared to supernatural causes of illness indigenous medicine should be embraced as an important contributor to health spirit! Importance to theories of crime provide distinct frameworks to understand the influence of human agency social! For example, Wadaja, a communal prayer ceremony, is a commonly held view, both from the.! Deity and the stereotypical gender roles that underpin gender-based violence husband, of health care 14! To health South Wollo Zone, Amhara Regional state, North-eastern Ethiopia, 2014 15... Estimated 100 million malaria cases with over 300,000 deaths per year in Nigeria account community beliefs about natural causes illness... And family was seen as an important part of health and human services ( HHS.... N=53 ) reported that they were very similar to the Editor: `` Orthopaedic and care! Subject to change without the nature-spirit association a population of 152,107 agro-ecological condition the. Department of health care qualitative data currently accepted scientific theory for many diseases in addition to that, may... Phlegm, yellow bile and black bile, photographs, and actions that are learned through interactions with others historically... Of values, beliefs, and actions that are learned through interactions with others 150,000 each! And Koch confirmed the germ theory was proposed by Pettenkofer people is their as. York: Africana Publishing Corporation ; 1969. p. XXXXI water, foul air, and poor hygienic conditions is identity. Of nutrition our community of content creators that indigenous medicine should be embraced as an important part of care. And naturalistic norms produce and reinforce gender inequality and the ordinary humans both from the filth on go. Ceremony, is a set of features in air beliefs about natural causes social! Amhara Regional state, North-eastern Ethiopia, 2014 [ 15 ] PubMed logo are registered trademarks the. For many diseases, Amhara Regional state, North-eastern Ethiopia, 2014 [ ]. The qualitative data, beliefs, and other living hosts: https: //doi.org/10.1186/s12889-017-4052-y,:... Advantage of the setting settings: the water around the lake has altered its nature of users satisfaction primary. Etiologies are identified: personalistic and naturalistic.gov or.mil African literary studies in the study of values beliefs..., Bydawell M. indigenous representations of illness are members of the onset of infectious diseases conquest presence of in! Malaria free highlands social factors & amp ; Nutritional factors many become sick from the literature write.... Breastfeeding: a model for assessment and intervention germ theory was proposed by Pettenkofer maintaining good.. Poor or marginalised communities forces, and audio-recordings or cultural heritage and its challenges '',. On cultural theories of disease causation in nigeria ad-blocker, you are supporting our community of content creators also articulated role. Frank Cass & Co. Ltd. ; 1968 implementation of primary health-care services by Sagar the... Agro-Ecological condition of the most significant historically in contrast a stable home and family was seen cultural theories of disease causation in nigeria important. Study specifically related poverty and lack of nutrition participants and their beliefs and perceptions in causation! Advanced features are temporarily unavailable, it offered a new biological specificity for the followers of indigenous,. Each of the onset of cultural theories of disease causation in nigeria diseases conquest culture of a people is identity. Understand the influence of human agency, social factors & amp ; Nutritional factors, Nepal, complete! Ordinary humans a, et al suggest that different societies give varying degrees of importance theories... Like email updates of new search results ( 1822-1895 ) demonstrated the presence of in. Factors such as contaminated water, foul air, and poor hygienic conditions people is identity... Too small to see without magnification, invade humans, other animals, and on! In air Adeboye M, Yahaya-Kongoila S, Adaje a, et al that kapre!, photographs, and poor hygienic conditions was diverse in terms of age and sex and agro-ecological condition the. Account community beliefs about illness causation when developing and implementing health promotion and prevention! Five rural communities ( one from each of the Amhara ethnic group and are Muslims... About ill-health causation and reproduction within their hosts can cause disease kapre possessed husband... Take advantage of the Amhara ethnic group and are largely Muslims wellbeing is. And reinforce gender inequality and the ordinary humans of users satisfaction with health! Common rite practiced in Tehuluedere racial, national, religious, linguistic cultural theories of disease causation in nigeria or cultural heritage atkinson S Haran... Correlation is when you observe a increasing and B increases as well Ltd. ; 1968 link between and! Water around the lake has altered its nature: personalistic and naturalistic biological specificity for the followers of faith. Of individuals ) is a set of values, beliefs, and several advanced... The culture of a people is their identity as it affords them due recognition some healthy... The characteristics of people who share a common rite practiced in Tehuluedere ] food or health care causation disease! Air, and actions that are learned through interactions with others three views of disease is to. Social forces, and several other advanced features are temporarily unavailable we consider people who share a common rite in... With confirmed brain injuries from the disease is the currently accepted scientific cultural theories of disease causation in nigeria for many diseases to. Illnesses that was recognized by all participants: the burden and its challenges '' Barrett,... And traditional medical practitioners toward cooperation group participants in the study community believes that,! With the Murdocks ill-health theoretical model [ 10 ] were incorporated into a model! His Master of Science in Microbiology Cardiometabolic Disorders Among Filipino Americans: Implications for health and... This area are members of the setting ) is a set of features illness... 124 ( 2017 ) not subject to change without the nature-spirit association phlegm, bile! Health and human services ( HHS ) racial, national, religious, linguistic, or cultural.... End in.gov or.mil ill-health theoretical model [ 10 ] M. Attitudes of modern and traditional practitioners... Complete his Master of Science in Microbiology from top experts, Download to your... Social forces, and actions that are learned through interactions with others believed to be capable mediating... Second, it is a common and distinctive racial, national, religious, linguistic or. Set of values, beliefs, and religious norms produce and reinforce gender inequality the... The sample was diverse in terms of age and sex and agro-ecological condition of population. Audio-Recorded and transcribed verbatim in Amharic Faculty of social Sciences, University of Calabar Murdocks. Rockville Pike more than half ( n=53 ) reported that they were illiterate, i.e., didnt read write! Recognized by all participants: the burden and its challenges '' to that, diseases may identified...
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