Mass anti-malarial administration in western Cambodia: a qualitative study of factors affecting coverage

Malaria Journal

Research

Chan Davoeung¹  Christopher Pell²  Lim Dara³  Ma Sareth³  Chhouen Heng³  Rupam Tripura⁴  Lorenz von Seidlein⁵  Phaikyeong Cheah⁵  Arjen Dondorp⁵  Thomas J. Peto⁵  Chea Nguon⁶ 

[1] Battambang Provincial Health Department, Krong Battambang, Cambodia;Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands;Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands;Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand;Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand;Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;Mahidol Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand;Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK;National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia;

关键词: Malaria;    Qualitative;    Attitudes;    Social factors;    Community engagement;    Mass drug administration;    Coverage;    Cambodia;   

DOI  :  10.1186/s12936-017-1854-4

 received in 2017-03-13, accepted in 2017-05-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundMass anti-malarial administration has been proposed as a key component of the Plasmodium falciparum malaria elimination strategy in the Greater Mekong sub-Region. Its effectiveness depends on high levels of coverage in the target population. This article explores the factors that influenced mass anti-malarial administration coverage within a clinical trial in Battambang Province, western Cambodia.MethodsQualitative data were collected through semi-structured interviews and focus group discussions with villagers, in-depth interviews with study staff, trial drop-outs and refusers, and observations in the communities. Interviews were audio-recorded, transcribed and translated from Khmer to English for qualitative content analysis using QSR NVivo.ResultsMalaria was an important health concern and villagers reported a demand for malaria treatment. This was in spite of a fall in incidence over the previous decade and a lack of familiarity with asymptomatic malaria. Participants generally understood the overall study aim and were familiar with study activities. Comprehension of the study rationale was however limited. After the first mass anti-malarial administration, seasonal health complaints that participants attributed to the anti-malarial as “side effects” contributed to a decrease of coverage in round two. Staff therefore adapted the community engagement approach, bringing to prominence local leaders in village meetings. This contributed to a subsequent increase in coverage.ConclusionFuture mass anti-malarial administration must consider seasonal disease patterns and the importance of local leaders taking prominent roles in community engagement. Further research is needed to investigate coverage in scenarios that more closely resemble implementation i.e. without participation incentives, blood sampling and free healthcare.

【 授权许可】

CC BY   
© The Author(s) 2017