Community acceptance of reactive focal mass drug administration and reactive focal vector control using indoor residual spraying, a mixed‐methods study in Zambezi region, Namibia

Malaria Journal

Patrick McCreesh¹  Brooke Whittemore¹  Alysse Maglior²  Kimberly Baltzell³  Michelle S. Hsiang⁴  Kathryn W. Roberts⁵  Cara Smith Gueye⁵  Henry Ntuku⁵  Roly Gosling⁶  Davis Mumbengegwi⁷  Petrina Uusiku⁸  Immo Kleinschmidt⁹ 

[1] Department of Pediatrics, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, USA;Malaria Elimination Initiative, Global Health Group, University of California, (UCSF), 550 16th St, San Francisco, CA, USA;Malaria Elimination Initiative, Global Health Group, University of California, (UCSF), 550 16th St, San Francisco, CA, USA;Department of Family Health Care Nursing, School of Nursing, UCSF, San Francisco, USA;Malaria Elimination Initiative, Global Health Group, University of California, (UCSF), 550 16th St, San Francisco, CA, USA;Department of Pediatrics, University of Texas, Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, USA;Department of Pediatrics, UCSF, San Francisco, USA;Malaria Elimination Initiative, Global Health Group, University of California, (UCSF), 550 16th St, San Francisco, CA, USA;Global Programs for Research and Training, Malaria Elimination Initiative Namibia, Windhoek, Namibia;Malaria Elimination Initiative, Global Health Group, University of California, (UCSF), 550 16th St, San Francisco, CA, USA;Global Programs for Research and Training, Malaria Elimination Initiative Namibia, Windhoek, Namibia;Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia;Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia;National Vectorborne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia;Wits Research Institute for Malaria, Wits/SAMRC Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa;Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK;Southern Africa Development Community Malaria Elimination Eight Secretariat, Windhoek, Namibia;

关键词: Malaria;    Plasmodium falciparum;    Malaria elimination;    Namibia;    Mass drug administration;    Indoor residual spraying;    Reactive case detection;    Community acceptability;    Qualitative and Mixed Methods;   

DOI  :  10.1186/s12936-021-03679-1

来源: Springer

【 摘 要 】

BackgroundIn Namibia, as in many malaria elimination settings, reactive case detection (RACD), or malaria testing and treatment around index cases, is a standard intervention. Reactive focal mass drug administration (rfMDA), or treatment without testing, and reactive focal vector control (RAVC) in the form of indoor residual spraying, are alternative or adjunctive interventions, but there are limited data regarding their community acceptability.MethodsA parent trial aimed to compare the effectiveness of rfMDA versus RACD, RAVC versus no RAVC, and rfMDA + RAVC versus RACD only. To assess acceptability of these interventions, a mixed-methods study was conducted using key informant interviews (KIIs) and focus group discussions (FGDs) in three rounds (pre-trial and in years 1 and 2 of the trial), and an endline survey.ResultsIn total, 17 KIIs, 49 FGDs were conducted with 449 people over three annual rounds of qualitative data collection. Pre-trial, community members more accurately predicted the level of community acceptability than key stakeholders. Throughout the trial, key participant motivators included: malaria risk perception, access to free community-based healthcare and IRS, and community education by respectful study teams. RACD or rfMDA were offered to 1372 and 8948 individuals in years 1 and 2, respectively, and refusal rates were low (< 2%). RAVC was offered to few households (n = 72) in year 1. In year 2, RAVC was offered to more households (n = 944) and refusals were < 1%. In the endline survey, 94.3% of 2147 respondents said they would participate in the same intervention again.ConclusionsCommunities found both reactive focal interventions and their combination highly acceptable. Engaging communities and centering and incorporating their perspectives and experiences during design, implementation, and evaluation of this community-based intervention was critical for optimizing study engagement.

【 授权许可】

CC BY