Acceptability and feasibility of malaria prophylaxis for forest goers: findings from a qualitative study in Cambodia

Malaria Journal

Christopher Pell¹  Franca Conradis-Jansen²  Mom Ean²  Kulchada Pongsoipetch²  Panarasri Khonputsa²  Chhoeun Heng²  Thoek Buntau²  Thomas J. Peto³  Monnaphat Jongdeepaisal³  Rupam Tripura³  James J. Callery³  Lorenz von Seidlein³  Richard J. Maude⁴  Siv Sovannaroth⁵  Ung Soviet⁶ 

[1] Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands;Department of Global Health, Amsterdam University Medical Centers - Location Academic Medical Center, Amsterdam, The Netherlands;Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands;Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK;Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK;Harvard TH Chan School of Public Health, Harvard University, Boston, USA;The Open University, Milton Keynes, UK;National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia;Provincial Health Department, Stung Treng, Stung Treng, Cambodia;

关键词: Forest goer;    Malaria;    Prophylaxis;    Acceptability;    Feasibility;   

DOI  :  10.1186/s12936-021-03983-w

来源: Springer

【 摘 要 】

BackgroundIn the Greater Mekong Subregion, adults are at highest risk for malaria, particularly those who visit forests. The absence of effective vector control strategies and limited periods of exposure during forest visits suggest that chemoprophylaxis could be an appropriate strategy to protect forest goers against malaria.MethodsAlongside a clinical trial of anti-malarial chemoprophylaxis in northern Cambodia, qualitative research was conducted, including in-depth interviews and observation, to explore the acceptability of malaria prophylaxis for forest goers, the implementation opportunities, and challenges of this strategy.ResultsProphylaxis with artemether–lumefantrine for forest goers was found to be acceptable under trial conditions. Three factors played a major role: the community’s awareness and perception of the effectiveness of prophylaxis, their trust in the provider, and malaria as a local health concern. The findings highlight how uptake and adherence to prophylaxis are influenced by the perceived balance between benefits and burden of anti-malarials which are modulated by the seasonality of forest visits and its influence on malaria risk.ConclusionsThe implementation of anti-malarial prophylaxis needs to consider how the preventive medication can be incorporated into existing vector-control measures, malaria testing and treatment services. The next step in the roll out of anti-malarial prophylaxis for forest visitors will require support from local health workers.

【 授权许可】

CC BY