Malaria risk factors and care-seeking behaviour within the private sector among high-risk populations in Vietnam: a qualitative study

Malaria Journal

Research

Ingrid Chen¹  Andrew Lover¹  Adam Bennett¹  Ngo Duc Thang²  Josselyn Neukom³  Huong Ngo Thi Thanh³  Tang Viet Luu³  Hoang Nghia Thang³  Phung Thi Thao³ 

[1] Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, 550 16th Street, 3rd Floor, 94158, San Francisco, CA, USA;National Institute of Malaria, Parasitology, and Entomology (NIMPE), Vietnam, 35 Trung Van, Tu Liem, Hanoi, Vietnam;Population Services International Vietnam, VinaFor Building, 127 Lò Đúc, Đồng Xuân, Hanoi, Vietnam;

关键词: Vietnam;    Malaria;    Care-seeking behavior;    Private sector;    High-risk population;    Migrant and mobile populations;   

DOI  :  10.1186/s12936-017-2060-0

 received in 2017-06-16, accepted in 2017-10-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundVietnam has successfully reduced malaria incidence by more than 90% over the past 10 years, and is now preparing for malaria elimination. However, the remaining malaria burden resides in individuals that are hardest to reach, in highly remote areas, where many malaria cases are treated through the informal private sector and are not reported to public health systems. This qualitative study aimed to contextualize and characterize the role of private providers, care-seeking behaviour of individuals at high risk of malaria, as well as risk factors that should be addressed through malaria elimination programmes in Vietnam.MethodsSemi-structured qualitative interviews were conducted with 11 key informants in Hanoi, 30 providers, 9 potential patients, and 11 individuals at risk of malaria in Binh Phuoc and Kon Tum provinces. Audio recorded interviews were transcribed and uploaded to Atlas TI™, themes were identified, from which programmatic implications and recommendations were synthesized.ResultsQualitative interviews revealed that efforts for malaria elimination in Vietnam should concentrate on reaching highest-risk populations in remote areas as well their care providers, in particular private pharmacies, private clinics, and grocery stores. Among these private providers, diagnosis is currently based on symptoms, leaving unconfirmed cases that are not reported to public health surveillance systems. Among at-risk individuals, knowledge of malaria was limited, and individuals reported not taking full courses of treatment, a practice that threatens selection for drug resistance. Access to insecticide-treated hammock nets, a potentially important preventive measure for settings with outdoor biting Anopheles vectors, was also limited.ConclusionsMalaria elimination efforts in Vietnam can be accelerated by targeting improved treatment, diagnosis, and reporting practices to private pharmacies, private clinics, and grocery stores. Programmes should also seek to increase awareness and understanding of malaria among at-risk populations, in particular the importance of using preventive measures and adhering to complete courses of anti-malarial medicines.

【 授权许可】

CC BY   
© The Author(s) 2017