| Abstract|| |
Background: Lay press creates awareness on issues related to health and illnesses, and thus influences the attitude of public. Objective: The present study was undertaken to find out the pattern of information provided in print media on Chikungunya fever and to elicit the readers' views. Materials and Methods: Information displayed on Chikungunya fever in one of the oldest English daily newspapers 'The Hindu' and its supplements published from Madurai and Chennai, India from April 1, 2006 to October 31, 2006 were read, analyzed, and classified into different categories. A readership questionnaire survey was carried out among policy makers (n = 25), health professionals (n = 170), medical students (n = 200), and the public (n = 150) to find out their preferences and usefulness on the category of information provided. The data were analyzed by simple descriptive statistics. Results: During the study period of 214 days, 74 items related to chikungunya fever, one in April, three in May, five in June, six in July, 15 in August, 18 in September, and 25 in October appeared. Most of the articles centered around the government policy matters (n = 37) and others in the order of preventive aspects (n = 32), statistics (n = 31), geographical distribution (n = 21), symptomatology (n = 16), transmission of illness (n=16), etc., Overall areas of interest of policy makers and health professionals were different significantly ( P < 0.01) from that of medical students and the public, but every one looked for treatment and preventive aspects. Conclusion: Media have provided information, improved knowledge, altered the attitude, and influenced decision making. It is suggested that students and researchers of health sciences should be motivated to read standard newspapers as it provides information on health and illnesses much earlier than they appear in their professional journals.
Keywords: Analysis, Chikungunya, India, media reports, newspaper, pattern, readership survey.
|How to cite this article:|
Thirumalaikolundusubramanian P, Srinivasan M, Vinodhkumaradithyaa A, Uma A. Chikungunya epidemic: Analysis of reports of a lay press. Ann Trop Med Public Health 2008;1:25-8
|How to cite this URL:|
Thirumalaikolundusubramanian P, Srinivasan M, Vinodhkumaradithyaa A, Uma A. Chikungunya epidemic: Analysis of reports of a lay press. Ann Trop Med Public Health [serial online] 2008 [cited 2020 Apr 10];1:25-8. Available from: http://www.atmph.org/text.asp?2008/1/1/25/43074
| Introduction|| |
Chikungunya fever, a rare form of viral fever, once prevalent in tropical forests of Africa, has made an epidemic entry into Asia in 1958 and India in 1963.  Though antibodies to chikungunya virus were observed in stored sera samples of patients who had an outbreak of febrile illness in1954,  descriptions similar to this illness were made in eighteenth century itself.  As there is no specific cure for this disease, prevention plays a major role in its control.  Lay press plays an important role in creating awareness, by discussing issues on health and illness, and has a strong influence on public attitude. Research analysis of newspaper reports on health and illness, events and highlights are few in medical journalism. Moreover to improve the quality of contents in print media, the past President of India, Honorable Dr. A. P. J. Abdul Kalam  has suggested to establish research wings in academic institutions. During medical education, though mention has been made on the role of media in information, education, and communication (IEC) activities for health and diseases, analytical component of media was not focused. However, modern journalism is seeking out academics to provide specialized analysis and opinion on the news of the day.  Hence the present study was undertaken to analyze the materials on chikungunya fever described in the print media to find out the pattern of information provided and to elicit the readers' views.
| Materials and Methods|| |
An English daily newspaper, The Hindu, published between April 1, and October 31, 2006 from Madurai and Chennai was chosen for the following reasons like consistency of publication from 1878, vast readership, publications from 12 centers, having Indian and International editions and supplements without additional cost, cross checks, verifies and looks for authenticity before printing, online availability at "www.thehindu.com" with search facilities, column for readers to express their views (letters to editor), another column for "corrections and clarifications," and follows the ethics of publication.
Any news item related to chikungunya fever that appeared in the newspaper and its' supplemental issues were looked carefully and collected. Each item was read, analyzed, and classified independently into different categories based on the predominant information into historical, geographical distribution, statistics, transmission, symptoms and signs, investigations, diagnosis, therapy, preventive aspects, policy matters and political issues, or a combination of more than one. The classification was done by every author based on the standard headings as required while writing a review article or monogram of an illness.
The opinion of any three authors if were consistent independently, the item was considered for that category. If it was different among them, the opinion of the senior author was sought and classified finally. Care was exercised to include only one of the two informations published on the same aspect in two different issues coming from Chennai and Madurai, either on the same day or on subsequent days. The information provided on the front page, editorial column, and figures/pictures were also noted, and included for analysis as these aspects attract readers.
Further a readership survey was carried out by means of a questionnaire survey with policy makers (n = 25), health professionals (n = 170), medical students (n = 200), public (n = 150) who read the Hindu newspaper regularly to find out if they had read the items on chikungunya fever published, and elicit their preferences and usefulness on the category of information provided. The health professionals included in the present study were faculty members (n - 55) and residents (n - 115) belonging to medical (n - 75) and medical subspecialties (n - 95) directly dealing with fever cases both in the outpatient and inpatient divisions. All of them belonged to multispecialty teaching hospitals affiliated to Tamilnadu Dr. M.G.R Medical University, Chennai. The data were analyzed by simple descriptive statistics.
| Results|| |
During the study period of 214 days, there were three holidays and hence the total number of newspapers issued was 211 which carried 74 items related to chikungunya fever. There was one news item in the month of April, three in May, five in June, six in July, 15 in August, 18 in September, and 25 in October.
The supplements issued along with the newspaper, the Hindu Health watch dated July 30, 2006 and another in Hindu Opportunities dated August 23, 2006 carried information on chikungunya fever. There were two informative editorials, one each on June 14 and September 23. In addition, the Ministry of Health and Family Welfare gave community-oriented information along with advertisements on October 23, 27, and 31, 2006 but in different forms.
Information on chikungunya fever was published on the front page of the newspaper on five occasions over a period of 7 months, one each during June, July and October, and twice in September. Information along with one or other picture related to the same was displayed on 16 occasions, one each on mosquito, mosquito swatter, fogging, breeding places, cleaning of water stagnation, preventive aspects, hospital related, drug distribution, social support and others.
Most of the articles centered around the government policy matters (n = 37) and others in the order of preventive aspects (n = 32), statistics (n = 31), geographical distribution (n = 21), symptomatology (n = 16), transmission of illness (n = 16), investigations (n = 14), political issues (n = 14), therapy (n = 13), diagnosis (n = 10) and historical data (n = 7). Interestingly, there were two items one on public discussion in October 12, 2006 and the other on chikungunya on tourism in October 21, 2006. The result of the readership survey is provided in [Table 1]. The areas of interest of policy makers and health professionals were different significantly ( P < 0.01) from that of medical students and the public, but every one looked for treatment and preventive aspects. However, every one made use of the information.
| Discussion|| |
Newspaper brings out a variety of information and health is one among them. Information related to health and illness is disseminated through lay press in simple and understandable form. Hence, these items are read by different strata of society who get sensitized much more than the professionals. Obviously, the frequency of publication of an item is influenced by the nature and persistence of the problem such as epidemics, and the readers get to know the details more and utilize the information for their personal life as well as share the knowledge with others.
Most of the articles on chikungunya fever appeared between August and October 2006 during which period large number of fever cases were reported to government and private health care centers in Tamilnadu. Well ahead of the medical journals discussing on chikungunya,  the Hindu newspaper started providing information on historical aspects, geographical distribution, statistics, transmission, symptoms and signs, therapeutic aspects, containment measures, policy matters, and political aspects which were useful to the policy makers, professionals, medical students, and the public as evidenced from the readership survey. In fact, professional medical journals ,,,,,, published from India brought out articles on chikungunya a bit later due to technical constraints. Less than 10% of the health professionals realized the out break initially through lay press report and the rest came to know the details through institutional circulars and initiatives taken by the health department of Tamilnadu state government within 2-3 months. Subsequently, it became a hot topic of discussion in the theory and practical classes of pharmacology, microbiology, community medicine, general medicine, and pediatric medicine.
The impressive words, sentences, and captions on chikungunya that appeared in the lay press were useful to convey the message to the community, educate the high school, and college students as well as public while employing the IEC methods. The messages that appeared in front page were sharp, concise, and carried multiple information which attracted the readers. Similarly, the pictures displayed in the newspaper were seen by all readers. As a result, the messages adjacent to it were also read by them. In other words, health messages displayed in front page, pictorial form, or as editorial article were read by the readers. Despite information on this illness appeared frequently in newspaper, tourist inflow was not affected  in this state of Tamilnadu, India.
Detailed analysis of the published items of chikungunya revealed an informative editorial  in June which dealt with the disease and epidemic aspects, and another editorial  in September which discussed on the credibility of scientific medicines and the honesty in acknowledging its limitations, as well as research aspects on drugs and vaccine against chikungunya. In the absence of definite medicines and vaccines, certain alternative medicines including siddha, homeopathy, and ayurveda had joined in the field of preventive medicines and cure. As a result, the official machineries of the state governments of Andhra Pradesh, Karnataka, Kerala, and Tamilnadu recommended alternative medicines. All these aspects were highlighted in the editorial article under the caption "a malady and some remedies."  Policy matters, health professionals, medical students, and the public were aware of these aspects only through newspapers. Unfortunately, many of the valuable information published in the lay press were not included in the published articles on chikungunya fever. ,,,,,,
Such an amount of information disseminated via lay press reaches millions of readers immediately. However, the areas of interest and utilization of information are influenced by the pre-existing knowledge, attitude, and concern. In view of the increased readership, the public get to know the details of diseases be it epidemic, endemic or pandemic, and sensitized. As a result, their expectations and demands are likely to be increased. So health professionals and administrators took all efforts to provide treatment and for containment, by way of organizing educational programs for community empowerment and their participation as their cooperation is required for disease containment and eradication.
The contents of item represented were reliable except for three discrepancies. In the media, it was mentioned that the first case was reported from Padukkapathu of Tuticorin, Tamilnadu contrary to Vellore as reported by Indian Council of Medical Research (ICMR). The former was based on clinical grounds and the latter was laboratory based. Second, the statistical data provided by the media were high probably because media persons get hearsay data from public and private sector, whereas the data provided by ICMR was lower as they get official reports from government machinery. Interestingly, in a report published on August 13, 2006, it was mentioned that chikungunya disease was caused by mosquitoes. However, it was corrected as being transmitted by mosquitoes in the "corrections and clarifications" section on August 15,2006, based on a letter written by one of the authors (A.U) to the editor of the newspaper. Hence, health professionals should also take care while reading lay press reports, analyze the contents, look with authenticity, compare the merits and demerits, and provide feedback to the editors of the press for the benefit of the public as well as to avoid conflicting ideas. In general, the lay press has provided early information on the outbreak and alerted authorities as well as professionals.
The epidemic has lead to the development of a diagnostic center for the disease in Madras Veterinary Medical College, Chennai (October 13, 2006), introduction of a Government order by way including it as a notifiable disease,  an educational program on preventive measures at schools (October 21, 2006), community-based approach to control vectors (October 3, 2006) and multistructural integrated vector management (October 8, 2006). By looking into the achievements following the epidemic, it is clear that lay press has provided information, improved knowledge, altered the attitude and influenced decision making. The strength of the study was collection of the published items regularly on daily basis, independent analysis by each author, consensus for interpretation and classification, as well as readership survey.
Analysis of information on health and illness published in the newspaper is another area for research in health sciences. It is suggested that students and researchers of health sciences should be motivated to read standard newspapers as it provides reliable information not only on health, but also on illness much earlier than they appear in their professional journals. The attractive title, caption, and presentation were of use for IEC activities, and students made use of them in their symposium, seminar, or case presentation.
In fact the past President of India, Honorable Dr. A. P. J. Abdul Kalam  wanted media academia interaction for the betterment of the community. Though the recent growth of Internet has challenged the traditional daily newspaper in America, newspapers have retained their position as the media of preference in India.  So the current media persons are no more news gatherers, just holding mirrors to events, but take care to do research, analyze and reprint, as they have specialized in journalism.
At this juncture, it is worth to recall the media freedom, which brings out public interest in journalism, an essential element of democracy. At the same time, media have to play a careful role between secrecy and liberty, privacy and transparency, and freedom and accountability, but within the regulations. 
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