Ann Neville Miller: University of Central Florida, Orlando, USA
Peter Ngure: African Population and Health Research Centre
DOI: 10.108 0/02500167.2015.1100646 Communicatio Volume 41 | Number 4 | 2015pp.523–542
Abstract
Tungiasis is a neglected parasitic skin disease widespread in resource-poor communities in sub-Saharan Africa, South America and the Caribbean. Stigmatisation of tungiasis sufferers has been identified as a key reason why tungiasis frequently progresses untreated in many parts of the world, however little research has investigated the specifics of tungiasis stigma or the communication strategies sufferers use to manage stigmatization. This article reports results of focus group and in-depth interviews regarding strategies used to manage tungiasis stigma from the perspective of persons living with tungiasis in Murang'a County, Kenya. Most frequently mentioned were withdrawal tactics. Participants also engaged in refutation strategies to deny responsibility for their condition. Implications for stigma management communication theory are discussed.
Introduction
Tungiasis is a neglected parasitic skin disease common in resource-poor communities in sub-Saharan Africa, South America and the Caribbean. It is caused by a small reddish-brown sand flea, Tunga penetrans (T. penetrans), which burrows into the host’s skin and lays up to a thousand fertilised eggs (Heukelbach and Ogbomoiko 2007; Heukelbach, De Oliveira and Hesse et al. 2001). In most cases T. penetrans infests the folds of the toes, inter-digital spaces, soles, heels, hands and knees (Chen, Thong and Jee 2011). In extreme infestations it can infect almost the entire body, leading to crippling disfigurement and ultimately death. Besides physical suffering, individuals and family members of persons with tungiasis suffer from stigma and are often isolated by their societies (Heukelbach and Ugbomoiko, 2007; Njau, Wanzala and Mutugi et al. 2012). Although research has investigated the pathology and control of T. penetrans (Feldmeier and Heukelbach 2003; Ugbomoiko, Ariza and Ofoezie et al. 2007), few studies have addressed characteristics of stigma in areas where the disease is endemic, or how infected persons communicate to manage that stigma. This research applied the tenets of stigma management communication theory (SMC – Meisenbach 2010) to explore these issues in Murang’a County, site of the highest tungiasis prevalence in Kenya. SMC predicts communicative coping mechanisms of stigmatised persons on the basis of their attitudes toward public perceptions of the stigmatised mark and its applicability to themselves, and provides a broad framework within which to analyse a range of communicative behaviours
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