Feasibility of repellent use in a context of increasing outdoor transmission: a qualitative study in rural Tanzania

Malaria Journal

Research

Ann H Kelly¹  Sarah Mtali²  Onyango Sangoro³  Sarah J Moore⁴ 

[1] Disease Control Department, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;Department of Sociology, Philosophy and Anthropology, University of Exeter, Byrne House, EX4 4PJ, Exeter, UK;Ifakara Health Institute, Box 74, Bagamoyo, Tanzania;Ifakara Health Institute, Box 74, Bagamoyo, Tanzania;Disease Control Department, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;Ifakara Health Institute, Box 74, Bagamoyo, Tanzania;Swiss Tropical and Public Health Institute, Department of Health Interventions, CH-4002, Socinstrasse, 57, Basel, Switzerland;University of Basel, Petersplatz 1, 4003, Basel, Switzerland;

关键词: Repellent;    Malaria;    Knowledge;    Attitude;    Perceptions;    Practice;   

DOI  :  10.1186/1475-2875-13-347

 received in 2014-05-13, accepted in 2014-08-28,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundExtensive employment of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has substantially reduced malaria morbidity and mortality in sub-Saharan Africa. These tools target indoor resting and biting vectors, and may select for vectors that bite and rest outdoors. Thus, to significantly impact this residual malaria transmission outdoors, tools targeting outdoor transmission are required. Repellents, used for personal protection, offer one solution. However, the effectiveness of this method hinges upon its community acceptability. This study assessed the feasibility of using repellents as a malaria prevention tool in Mbingu village, Ulanga, Southern Tanzania.MethodologyChange in knowledge, attitude and practice (KAP) in relation to repellent use was assessed before and after the implementation of a cluster randomized clinical trial on topical repellents in rural Tanzania where repellent and placebo lotion were provided free of charge to 940 households for a period of 14 months between July 2009 and August 2010. Compliance, defined as the number of evenings that participants applied the recommended dose of repellent every month during the study period, was assessed using questionnaires, administered monthly during follow up of participants in the clinical trial. Focus group discussions (FGDs) were conducted in the same community three years later to assess the community’s KAP in relation to repellents and preference to different repellent formats.ResultsAt baseline, only 0.32% (n = 2) households in the intervention arm and no households in the control arm had ever used topical repellents. During follow-up surveys, significantly more households, 100% (n = 457) in intervention arm relative to the control, 84.03% (n = 379), (p = <0.001) perceived the repellent to be effective.Post-study, 99.78% (n = 462) and 99.78% (n = 463), (p = 0.999) in the intervention and control arms respectively, were willing to continue repellent use. Mosquito nuisance motivated repellent use. From the FGDs, it emerged that most respondents preferred bed nets to repellents because of their longevity and cost effectiveness.ConclusionHigh repellent acceptability indicates their feasibility for malaria control in this community. However, to improve the community’s uptake of repellents for use complimentary to LLINs for early evening and outdoor protection from mosquito bites, longer lasting and cheap formats are required.

【 授权许可】

CC BY   
© Sangoro et al.; licensee BioMed Central Ltd. 2014