Peer Review- The Role of Community in Malaria Vector Control

There are 40% (3 billion) of the world's population at risk of suffering from malaria with the addition of some 300-500 million cases and 1.5 to 1.7 million people died from suffering from malaria. In Indonesia to date, infectious disease, especially diseases that are transmitted by animals, especially insects, are still a public health problem. This study aimed to determine the role of the community in the prevention, control and eradication of malaria. This research was a qualitative study. Subjects of the study were public, community leaders, and health care providers. Data were analyzed by using content analysis and theory validation source. Community participation in malaria vector control through several ways to eradicate mosquito breeding, usage of mosquito nets, use of insect repellent, avoiding a night out and a survey of patients who return from leave. The community plays an active role in malaria vector control efforts by closing puddles, community service every week, and some people are already using nets.

We surveyed adults in a randomly selected sample of 1,000 households in 50 villages in nine malarial sub-districts in Purworejo, central Java, Indonesia from May to July 2001. The survey assessed malaria knowledge, attitudes, and practices in communities experiencing epidemic malaria to begin exploring broad strategies for controlling the disease in the region. A pre-tested survey instrument consisting of 93 questions addressed demographic characteristics, socioeconomic factors, knowledge and perceptions of malaria, burden and severity of disease, treatment-seeking behavior, malaria prevention practices, and perceptions of government malaria control efforts. The survey was taken by in-person interview of all subjects. Most (97%) subjects were aware of malaria and more than two-thirds correctly identified mosquitoes as the vector. Forty-one percent of households in both forest/hilly and agricultural/urban areas reported malaria illness in the past year. Thirty-six percent (357 households) owned at least one bed net, 92% of these had been purchased by the owners. However, only 36% of households with bed nets affirmed their use as a means of preventing malaria. Nearly all respondents reported a willingness to accept spraying of residual insecticides for malaria prevention, yet less than 5% were willing to pay a nominal fee (US $3) for this service. Fifty-two percent of respondents reported self-treatment of malaria illness without visiting a health facility. This assessment of knowledge, attitudes, and practices showed a broad awareness of malaria and its consequences among residents of malarial areas in the Menoreh Hills of Central Java.

Malaria Journal, 2010

Background: In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the southwest Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging. Method: Nine focus group discussions (FGDs), 12 key informant interviews (KIIs), three transect walks and seven participatory workshops were carried out in three villages across Tanna Island to investigate community perceptions and practices relating to malaria prevention (particularly relating to bed nets); influences on these practices including how malaria is contextualized within community health and disease priorities; and effective avenues for channelling health information. Results: The primary protection method identified by participants was the use of bed nets, however, the frequency and motivation for their use differed between study villages on the basis of the perceived presence of malaria. Village, household and personal cleanliness were identified by participants as important for protection against malaria. Barriers and influences on bed net use included cultural beliefs and practices, travel, gender roles, seasonality of mosquito nuisance and risk perception. Health care workers and church leaders were reported to have greatest influence on malaria prevention practices. Participants preferred receiving health information through visiting community health promotion teams, health workers, church leaders and village chiefs. Conclusion: In low malaria transmission settings, a package for augmenting social capital and sustaining community participation for elimination will be essential and includes: 'sentinel sites' for qualitative monitoring of evolving local socio-cultural, behavioural and practical issues that impact malaria prevention and treatment; mobilizing social networks; intersectoral collaboration; integration of malaria interventions with activities addressing other community health and disease priorities; and targeted implementation of locally appropriate, multi-level, media campaigns that sustain motivation for community participation in malaria elimination.

Environmental Economics, 2016

Malaria prevention and control programs in Zimbabwe have been hampered by low levels of cooperation by local communities. The study sought to assess the impact of community participation on cooperation in malaria prevention and control programs in Binga, Gokwe and Kariba districts in Zimbabwe. This study is aimed at synthesizing, comparing and contrasting data from these three districts which are, arguably, the most prone to malaria in the country. An intensive and extensive review of related literature was done on the impact of community participation on cooperation in malaria prevention and control. The literature reviewed was focusing on three districts in the country, namely, Binga, Gokwe and Kariba. Typologies of participation were used for the measurement of levels of participation, while analysis was descriptive. Findings revealed that the levels of participation in malaria prevention and control programs in Binga and Gokwe were low, but high in Kariba. The findings from Kari...

Annals of Tropical Medicine & Public Health

Background: Purworejo, Magelang, and Kulonprogo are the three known regencies that have not yet received a Malaria elimination certificate in Central Java and Yogyakarta. Therefore, interventions system in the form of health education are required in these regions. Aims:The purpose of this study is to determine the community practice in preventing Malaria following the provided intervention in the form of counseling by religious and community leaders.Settings and Design: This research adopted a quasi-experimental approach and was performed in Purworejo, Magelang, and Kulon Progo Areas, Central Java Province, and Daerah Istimewa Yogyakarta.Methods and Material:The provided interventions in the form of counseling were conducted at community groups in the study sites in 6 villages, 3 districts, with 384 people. And were carried out by educating the community through their leaders on the importance of preventing the spread of malaria through health instructions, related movies, distribution of smartbooks, and training on the practice of hunting Anopheles larvae. Statistical analysis used: Data analysis was performed using the chi-square test in identifying the differences in community knowledge before and after conducting the intervention.Results: The results showed that intervention in the form of counseling changed the communities' behaviour towards malaria in the three districts (p<0.05). This involved their protective efforts against mosquito bites, night out activity, and installation of bed net and sleeping inside it. Conclusions: The health education

Human Resources for Health, 2011

Background: Community participation in vector control and health services in general is of great interest to public health practitioners in developing countries, but remains complex and poorly understood. The Urban Malaria Control Program (UMCP) in Dar es Salaam, United Republic of Tanzania, implements larval control of malaria vector mosquitoes. The UMCP delegates responsibility for routine mosquito control and surveillance to community-owned resource persons (CORPs), recruited from within local communities via the elected local government. Methods: A mixed method, cross-sectional survey assessed the ability of CORPs to detect mosquito breeding sites and larvae, and investigated demographic characteristics of the CORPs, their reasons for participating in the UMCP, and their work performance. Detection coverage was estimated as the proportion of wet habitats found by the investigator which had been reported by CORP. Detection sensitivity was estimated as the proportion of wet habitats found by the CORPS which the investigator found to contain Anopheles larvae that were also reported to be occupied by the CORP. Results: The CORPs themselves perceived their role as professional rather than voluntary, with participation being a de facto form of employment. Habitat detection coverage was lower among CORPs that were recruited through the program administrative staff, compared to CORPs recruited by local government officials or health committees (Odds Ratio = 0.660, 95% confidence interval = [0.438, 0.995], P = 0.047). Staff living within their areas of responsibility had > 70% higher detection sensitivity for both Anopheline (P = 0.016) and Culicine (P = 0.012): positive habitats compared to those living outside those same areas. Discussion and conclusions: Improved employment conditions as well as involving the local health committees in recruiting individual program staff, communication and community engagement skills are required to optimize achieving effective community participation, particularly to improve access to fenced compounds. A simpler, more direct, less extensive community-based surveillance system in the hands of a few, less burdened, better paid and maintained program personnel may improve performance and data quality.

Introduction: Malaria is a global problem, which incapacitates and kills many people. It's the leading cause of morbidity and mortality in Uganda. Tororo, one of the districts in Uganda, because of its warm climate and numerous swamps, which provide a favourable environment for breeding of the vector mosquito, has high malaria prevalence. Objective: To determine the knowledge, attitudes and practices of the household community on malaria, its transmission and control with the aim of providing information for planning community oriented malaria control activities. Design: A Cluster Survey. Setting: Tororo District Rural Community. Participants: 320 Heads of Households. Households randomly sampled through a multistage cluster sampling design. Interventions: Recommendations incorporated in National and District Malaria Control Plans. Main Outcome Measure(s): Knowledge, Attitudes and Practices of Household communities on malaria and its control. Results: 84% peasants with US$ 5 monthly income. All had heard of malaria. The local term for malaria was the term for 'fever'. Malaria rated as serious problem by 88%. 69% knew malaria transmission, but only 54% mentioned mosquitoes. Malaria incidence was 145/1000, and children more affected. 62.8% knew a control method. Mosquitoes are abundant during April to July. 39% mentioned inside the house as the mosquito resting place during the day, but 84% knew mosquito breeding sites. There was a strong association between formal education and knowledge of a control method [Odds Ratio = 2.09 (1.20 <OR< 3.64)]. Chloroquine most used in malaria treatment, 43.5% practised self-medication. 22% preferred pregnant women treated with lower dose of drugs. 62.8% used some control method, with only 8% using bed-nets, 86% not impregnated. The average cost of a bed-net was US$ 10. Bed-nets mainly used to protect against mosquito bites. Only 0.9% used bed-nets for privacy and protection against flies. There was a strong association between formal education and use of a control method [Odds Ratio = 2.41 (1.38 <OR< 4.20)]. Similarly, the more educated a respondent was, the more likely he used a bed net (Chi square for linear trend = 18.54; p-value <0.01). Traditional method most used was smoking (16.9%), Commercial method most used was coils (29.2%), Environmental method most used was peri-domestic bush clearing (11.2%). In 89.6% of the houses, mosquitoes were spotted. Ventilation present in 66% of the houses, 88% of which had no mesh. 94% of windows had no wire-mesh. 64% of the homesteads had breeding sites. Compounds clean in 72% and peri-domestic bush cleared in 42.5% of the homesteads. Main constraints to control were lack of awareness (49.5%), and poverty (31.9%). Conclusions: Majority were poor peasants with poor education, but had fairly good knowledge on malaria transmission and control. Both traditional and modern control methods were being practised albeit poorly. Bed-nets were scarce and expensive. Ventilation and domestic environment poor. Major constraints to control were lack of community awareness and poverty. Recommendations: Home improvement campaigns; community education on methods of control; purchase of bed-nets on a community revolving fund basis; initiation of community based vector control programs be launched; Formal education and adult literacy should be particularly encouraged and supported.

Malaria Journal, 2018

Background: There is growing interest to add mass drug administration (MDA) to the already existing malaria prevention strategies, such as indoor residual spraying (IRS). However, successful MDA and IRS requires high population-wide coverage, emphasizing the importance of community acceptance. This study's objectives were to identify community-level facilitators and barriers during the implementation of both MDA and IRS in communities with high malaria transmission intensity. Methods: This was a qualitative study conducted in two sub-counties in Katakwi district. Kapujan sub-county residents received two rounds of IRS and MDA while Toroma sub-county residents received two rounds of IRS only. Key informant interviews and focus group discussions were conducted with key influential district and sub-county personnel and community members. Data were analysed using thematic analysis. Transcripts and interview notes from the in-depth interviews were analysed using a coding scheme developed from pre-defined topics together with themes emerging from the data. The Nvivo software program was used to aggregate the data by codes and to present study findings. Results: Overall, 14 key informants were interviewed: 4 from Katakwi district and 5 each from Kapujan and Toroma sub-counties. Five focus group discussions were conducted: 4 with community members (men and women), 2 in each sub-county and one with medical staff of Toroma health centre IV. Important themes for consideration raised by the respondents include community sensitization, conducting implementation during the low activity dry season, involvement of government and local leadership, use of the competent locally composed team, community knowledge of malaria effects and consequences, combining interventions and evidence of malaria reduction from interventions. Potential barriers such as spreading of misinformation regarding interventions, the strong unpleasant smell from Actellic and inadequate duration of engagement with the community should be taken into consideration. Conclusion: This study documents important community engagement strategies that need to be considered when implementing malaria MDA in combination with IRS, for malaria prevention in such settings. This information is useful for malaria programmes, especially during the design and implementation of such community level interventions.

Malaria Journal, 2011

Background: In the 1990s, the experience of eliminating malaria from Aneityum Island, Vanuatu is often given as evidence for the potential to eliminate malaria in the south-west Pacific. This experience, however, cannot provide a blueprint for larger islands that represent more complex social and environmental contexts. Community support was a key contributor to success in Aneityum. In the context of disappearing disease, obtaining and maintaining community participation in strategies to eliminate malaria in the rest of Tafea Province, Vanuatu will be significantly more challenging.

Thomas Calculus Thirteenth Editions