Emerging properties of malaria transmission and persistence in urban Accra, Ghana: evidence from a participatory system approach

Malaria Journal

Christian Borgemeister¹  Merveille Koissi Savi¹  Daniel Callo-Concha²  Henri E. Z. Tonnang³ 

[1] Center for Development Research (ZEF), University of Bonn, 53113, Bonn, Germany;Center for Development Research (ZEF), University of Bonn, 53113, Bonn, Germany;Institute for Environmental Sciences (iES), University of Koblenz-Landau, 76829, Landau, Germany;International Centre for Insect Physiology and Ecology (Icipe), Nairobi, Kenya;

关键词: Network analysis;    Causal loop diagram;    Emergence;    Urban;    Complex system;   

DOI  :  10.1186/s12936-021-03851-7

来源: Springer

【 摘 要 】

BackgroundSeveral studies that aim to enhance the understanding of malaria transmission and persistence in urban settings failed to address its underlining complexity. This study aims at doing that by applying qualitative and participatory-based system analysis and mapping to elicit the system’s emergent properties.MethodsIn two experts’ workshops, the system was sketched and refined. This system was represented through a causal loop diagram, where the identification of leverage points was done using network analysis.Results45 determinants interplaying through 56 linkages, and three subsystems: urbanization-related transmission, infection-prone behaviour and healthcare efficiency, and Plasmodium resistance were identified. Apart from the number of breeding sites and malaria-positive cases, other determinants such as drug prescription and the awareness of householders were identified by the network analysis as leverage points and emergent properties of the system of transmission and persistence of malaria.ConclusionBased on the findings, the ongoing efforts to control malaria, such as the use of insecticide-treated bed nets and larvicide applications should continue, and new ones focusing on the public awareness and malaria literacy of city dwellers should be included. The participatory approach strengthened the legitimacy of the recommendations and the co-learning of participants.

【 授权许可】

CC BY