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Glozah FN, Tabong PTN, Bazant E, Asampong E, Hornuvo R, Nwameme A, Peprah NY, Chandi GM, Adongo PB, Dako-Gyeke P. Implementation and effectiveness outcomes of Community Health Advocacy Teams to improve long-lasting insecticide net distribution and use in six districts in Ghana: A one-group pre-post-test study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002123. [PMID: 38557578 PMCID: PMC10984411 DOI: 10.1371/journal.pgph.0002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024]
Abstract
Malaria remains a leading cause of illness and death especially among children and pregnant women in Ghana. Despite the efforts made by the National Malaria Elimination Programme (NMEP), including distribution of Long-Lasting Insecticide Nets (LLINs) to households through periodic Point Mass Distribution (PMD) campaigns and continuous channels (antenatal, schools and postnatal), there is a gap between access and use of LLINs in Ghana. An effective and functional community-based group that would seek to improve the effectiveness of LLIN distribution before, during, after PMD Campaigns and continuous distribution at the community level could help address this gap. This paper assesses the implementation outcomes and short-term effectiveness of the pilot implementation of co-created community health advocacy teams (CHAT) intervention in Ghanaian communities to plan and implement campaigns to increase LLIN use. The study employed a one-group pre-post study design and measured implementation outcomes (acceptability, appropriateness, and feasibility) and effectiveness outcomes (LLIN awareness, LLIN access, willingness to purchase LLIN, and LLIN use) among 800 community households. The CHAT intervention was implemented for four months across six districts in the Eastern and Volta regions of Ghana. The data were downloaded directly from REDCap and analyzed statistically (descriptive and McNemar test of association) using SPSS 22 software. After the implementation period, the majority of respondents in all six districts indicated that the CHAT intervention was acceptable (89.8%), appropriate (89.5%), and feasible (90%). Also, there was a significant association between baseline and end-line assessment on all four effectiveness outcome measures. Household members' awareness of, access to, willingness to purchase, and use of LLINs increased significantly over the four-month period that the CHAT intervention was implemented. The study concludes that CHAT is an acceptable, appropriate, and feasible intervention for supporting the National Malaria Programme in LLIN PMD and for engaging in Social and Behaviour Change Communication activities through the continuous channels of distribution. Additionally, the CHAT demonstrates short-term effectiveness outcomes in terms of creating LLIN awareness, providing access to LLIN, and encouraging Ghanaian community members to be willing to purchase and use LLINs. Although the activities of CHAT members were largely voluntary, integration into the existing primary health care system will make it sustainable.
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Affiliation(s)
- Franklin N. Glozah
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Philip Teg-Nefaah Tabong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Eva Bazant
- Health Campaign Effectiveness Coalition, Task Force for Global Health, Decatur, Georgia, United States of America
| | - Emmanuel Asampong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Ruby Hornuvo
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Adanna Nwameme
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | | | - Gloria M. Chandi
- Ghana Health Service, Ga North Municipal Health Directorate, Greater Accra, Ghana
| | - Philip Baba Adongo
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Phyllis Dako-Gyeke
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
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Tarimo FS, Dillip A, Kosia EM, Lwetoijera DW. Community perception of the autodissemination of pyriproxyfen for controlling malaria vectors in south-eastern Tanzania. Malar J 2023; 22:333. [PMID: 37924148 PMCID: PMC10625276 DOI: 10.1186/s12936-023-04773-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/26/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND The efficacy of the autodissemination of pyriproxyfen to control malaria vectors has been demonstrated under semi field environment in Tanzania. However, the information on how best communities should be engaged for its routine and large-scale adoption are lacking. This study assessed the community's level of knowledge, perceptions, acceptability of the autodissemination of pyriproxyfen, and the perceived risks on the safety of pyriproxyfen on the environment. METHODS This was a concurrent mixed methods study, comprised of a community-based survey of 400 household representatives and eight focus group discussions (FGDs). The study was conducted in two villages in Mlimba district in south-eastern Tanzania between June and August 2022. For the quantitative data analysis, descriptive statistics were applied using R software, while inductive approach was used for qualitative data analysis, using NVivo software. RESULTS Knowledge on autodissemination of pyriproxyfen approach was found to be relatively low among both the FGD respondents and surveyed community members (36%, n = 144). Nevertheless, when it was explained to them, the envisioned community support for the autodissemination approach was relatively high (97%, n = 388). One of the major perceived benefits of the autodissemination of pyriproxyfen was the reduction of malaria-transmitting mosquitoes and associated malaria transmission. Environmental impact of pyriproxyfen on non-target organisms and health risk to children were among the major concerns. When provided with information on the safety and its utilization particularly through autodissemination approach, 93.5% (n = 374) of the survey respondents said that they would allow the PPF-contaminated pots to be placed around their homes. Similarly, FGD respondents were receptive towards the autodissemination of pyriproxyfen, but emphasized on the need for raising awareness among community members before related field trials. CONCLUSION This study indicates a low knowledge but high support for scaling up of the autodissemination of pyriproxyfen as a complementary tool for malaria control in rural Tanzania. The Findings of this study suggest that community sensitization activities are required to improve the community's acceptability and trust of the approach before respective field trials.
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Affiliation(s)
- Felista S Tarimo
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Ifakara, United Republic of Tanzania.
- School of Life Sciences and Bio Engineering, The Nelson Mandela, African Institution of Science and Technology, P. O. Box 4447, Tengeru, Arusha, United Republic of Tanzania.
| | - Angel Dillip
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Ifakara, United Republic of Tanzania
- School of Life Sciences and Bio Engineering, The Nelson Mandela, African Institution of Science and Technology, P. O. Box 4447, Tengeru, Arusha, United Republic of Tanzania
- Apotheker Health Access Initiative, P. O. Box 70022, Dar es Salaam, United Republic of Tanzania
| | - Efraim M Kosia
- School of Life Sciences and Bio Engineering, The Nelson Mandela, African Institution of Science and Technology, P. O. Box 4447, Tengeru, Arusha, United Republic of Tanzania
| | - Dickson W Lwetoijera
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Ifakara, United Republic of Tanzania.
- School of Life Sciences and Bio Engineering, The Nelson Mandela, African Institution of Science and Technology, P. O. Box 4447, Tengeru, Arusha, United Republic of Tanzania.
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Knowledge, practices and perceptions of communities during a malaria larviciding randomized trial in the city of Yaoundé, Cameroon. PLoS One 2022; 17:e0276500. [PMID: 36327271 PMCID: PMC9632894 DOI: 10.1371/journal.pone.0276500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/08/2022] [Indexed: 11/06/2022] Open
Abstract
Background Urban malaria is becoming a major public health concern in major cities in Cameroon. To improve malaria vector control, a pilot larviciding trial was conducted to assess its impact on mosquito density and malaria transmission intensity in Yaoundé. The present study investigated perceptions and practices of communities on malaria control during the larviciding trial implemented in Yaoundé. Methods Quantitative and qualitative data were collected in non-intervention and intervention areas. Quantitative data were collected during three cross-sectional surveys using a structured pre-tested questionnaire while qualitative data were obtained through interviews. A total of 26 in-depth interviews and eight focus group discussions with community members were performed. A binary logistic regression model was used to assess the perception of the community on larviciding impact on some malaria or bed nets use indicators. Results People living in intervention areas were 2.64 times more likely to know the mode of malaria transmission (95% CI: 1.82–3.84; p<0.001) and 1.3 time more likely to know mosquito breeding habitats (95% CI: 1.06–1.56; p = 0.009) compared to those living in non-intervention areas. In intervention areas, interviewee opinions on larviciding were generally good i.e. most interviewees reported having noticed a reduction in mosquito nuisance and malaria cases following larviciding implementation; whereas in non-intervention areas no report of reduction of mosquito nuisance was recorded. LLINs were regularly used by the population despite the implementation of larviciding treatments. There was high interest in larviciding program and demand for continuation, even if this needs the community involvement. Conclusion The larviciding program in the city of Yaoundé did not negatively affected community members’ behaviour and practices concerning the use of treated nets. The study indicated the acceptance of larviciding program by the population. This positive environment could favour the implementation of future antilarval control activities in the city of Yaoundé.
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Matindo AY, Kalolo A, Kengia JT, Kapologwe NA, Munisi DZ. The Role of Community Participation in Planning and Executing Malaria Interventions: Experience from Implementation of Biolarviciding for Malaria Vector Control in Southern Tanzania. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8046496. [PMID: 36193319 PMCID: PMC9525780 DOI: 10.1155/2022/8046496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 07/25/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022]
Abstract
Background Malaria remains a disease of great public health importance in 85 countries globally. Developing countries face resource constraints in implementing public health interventions aiming at controlling malaria. Promoting community participation may contribute to rational and effective use of resources and therefore facilitating achievement of intervention goals in a cost-effective manner while fostering sustainability. However, this can be possible if the community is engaged at all stages of the intervention, from designing, implementation, monitoring, and evaluation of results. This study aimed at understanding community participation in the implementation of a biolarviciding intervention for malaria vectors control in Southern Tanzania. Methods The current study adopted explanatory mixed method study design in collecting data. Quantitative data were collected from 400 community members and 12 vector control coordinators using structured questionnaire while qualitative data was collected through key informant interviews to 32 participants and in-depth interviews to 5 vector control coordinators who were purposively selected from the 12 councils. Quantitative data analysis involved descriptive and inferential statistics. Thematic analysis was used to analyse qualitative data. Results Of 400 community members, only 90 (22.5%) participated in biolarviciding implementation. Predictors of community participation were willingness to participate (AOR = 3.15, 95%CI = 1.14 - 8.71, P value = 0.027) and community involvement (AOR = 6.07, 95%CI = 2.69 - 13.71, P value < 0.001). The study revealed that the main barriers to community participation were lack of effective involvement and lack of incentive to community volunteers while high willingness to participate was a facilitating factor for community participation. Conclusion The study revealed low community participation in biolarviciding implementation in Southern Tanzania with willingness to participate and community involvement being the main predictors for community participation while lack of incentive to community volunteers was one major barrier to community participation. This explains the persistence of an unresolved challenge of community participation in malaria interventions. Therefore, more efforts are needed to improve the participation of community members in Malaria interventions through advocacy, awareness creation of respective roles, and responsibilities of the community members and fostering community ownership. Additionally, councils need to design customized motivation package for the community members.
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Affiliation(s)
- Athuman Yusuph Matindo
- Department of Health, Musoma District Council, Mara Region, Tanzania
- Department of Public Health and Community Nursing, School of Nursing and Public Health, The University of Dodoma, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health and Allied Sciences, Ifakara, Tanzania
- Center for Reforms, Innovation, Health Policies and Implementation Research (CeRIHI), P.O. Box 749, Morogoro Road, Makole (Near Bunge Premises) P.O. Box 749, Dodoma, Tanzania
| | - James Tumaini Kengia
- Center for Reforms, Innovation, Health Policies and Implementation Research (CeRIHI), P.O. Box 749, Morogoro Road, Makole (Near Bunge Premises) P.O. Box 749, Dodoma, Tanzania
- Department of Health, Social Welfare and Nutrition Services, President's Office Regional Administration and Local Government (PORALG), Dodoma, Tanzania
| | - Ntuli Angyelile Kapologwe
- Center for Reforms, Innovation, Health Policies and Implementation Research (CeRIHI), P.O. Box 749, Morogoro Road, Makole (Near Bunge Premises) P.O. Box 749, Dodoma, Tanzania
- Department of Health, Social Welfare and Nutrition Services, President's Office Regional Administration and Local Government (PORALG), Dodoma, Tanzania
| | - David Zadock Munisi
- Department of Microbiology and Parasitology, School of Medicine and Dentistry, The University of Dodoma, Tanzania
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Derua YA, Tungu PK, Malima RC, Mwingira V, Kimambo AG, Batengana BM, Machafuko P, Sambu EZ, Mgaya YD, Kisinza WN. Laboratory and semi-field evaluation of the efficacy of Bacillus thuringiensis var. israelensis (Bactivec®) and Bacillus sphaericus (Griselesf®) for control of mosquito vectors in northeastern Tanzania. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2022; 2:100089. [PMID: 35664894 PMCID: PMC9157456 DOI: 10.1016/j.crpvbd.2022.100089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 04/11/2022] [Accepted: 04/27/2022] [Indexed: 10/25/2022]
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Rulisa A, van Kempen L, Mutesa L, Hakizimana E, Ingabire CM, Kateera F, Koenraadt CJM, van Vugt M, van den Borne B. Willingness to Contribute to Bio-Larviciding in the Fight against Malaria: A Contingent Valuation Study among Rice Farmers in Rwanda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11575. [PMID: 34770086 PMCID: PMC8583195 DOI: 10.3390/ijerph182111575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/25/2021] [Accepted: 10/31/2021] [Indexed: 01/17/2023]
Abstract
There is broad consensus that successful and sustained larval source management (LSM) interventions, including bio-larviciding campaigns, require embeddedness in local community institutions. Ideally, these community structures should also be capable of mobilizing local resources to (co-)finance interventions. To date, farmer cooperatives, especially cooperatives of rice growers whose economic activity facilitates mosquito breeding, have remained under the radar in designing community-based bio-larviciding campaigns. This study explores the potential of rice farmer cooperatives in Bugesera district, Rwanda, to take up the aforementioned roles. To this purpose, we surveyed 320 randomly selected rice farmers who belonged to one of four rice cooperatives in the area and elicited their willingness-to-pay (WTP) for application of Bti, a popular bio-larvicide, in their rice paddies. Results from a (non-incentivized) bidding game procedure, which tested two alternative contribution schemes showed that financial contributions would be significantly different from zero and sufficient to carry a co-financing share of 15-25 per cent. A strong heterogeneity in mean WTP is revealed across cooperatives, in addition to variation among individual farmers, which needs to be anticipated when engaging farmer cooperatives in LSM.
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Affiliation(s)
- Alexis Rulisa
- Medical Research Centre Division, Rwanda Biomedical Centre, Kigali 7162, Rwanda;
- Department of Cultural Anthropology and Development Studies, Radboud University, 6525 Nijmegen, The Netherlands
| | - Luuk van Kempen
- Department of Cultural Anthropology and Development Studies, Radboud University, 6525 Nijmegen, The Netherlands
| | - Leon Mutesa
- Center for Human Genetics, College of Medicine and Health Sciences, University of Rwanda, Kigali 4285, Rwanda;
| | - Emmanuel Hakizimana
- Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Kigali 7162, Rwanda;
| | - Chantal M. Ingabire
- Medical Research Centre Division, Rwanda Biomedical Centre, Kigali 7162, Rwanda;
| | - Fredrick Kateera
- Academic Medical Center, Department of Infectious Diseases, University of Amsterdam, 1012 Amsterdam, The Netherlands;
| | | | - Michèle van Vugt
- Center for Tropical Medicine and Travel Medicine, Academic Medical Center, University of Amsterdam, 1012 Amsterdam, The Netherlands;
| | - Bart van den Borne
- Department of Health Education & Promotion, Maastricht University, 6211 Maastricht, The Netherlands;
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Matindo AY, Kapalata SN, Katalambula LK, Meshi EB, Munisi DZ. Biolarviciding for malaria vector control: Acceptance and associated factors in southern Tanzania. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2021; 1:100038. [PMID: 35284879 PMCID: PMC8906130 DOI: 10.1016/j.crpvbd.2021.100038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/23/2021] [Accepted: 06/15/2021] [Indexed: 06/14/2023]
Abstract
In the struggle towards malaria elimination, the government of Tanzania scaled up nationwide biolarviciding to supplement existing vector control measures. As with any community-based intervention, success of biolarviciding depends on acceptability to the community. This study sought to ascertain acceptance of biolarviciding among communities in southern Tanzania. A mixed-method study involved administration of questionnaires to 400 community members, with 32 key informant interviews and five in-depth interviews also held in selected councils of southern Tanzania. A multistage sampling method was employed in selecting community members, with purposive sampling used in selecting key informant and in-depth interviewees. The study found high community acceptance (80.3%) despite very low (19.3%) knowledge on biolarviciding. Community perception that biolarvicide is effective in reducing malaria infection was found to be a significant predictor of community acceptance to biolarviciding: those who perceived biolarvicide as effective in reducing malaria were five times more likely to accept biolarviciding compared to those with a negative perception (odds ratio = 4.67, 95% CI: 1.89-11.50, P = 0.001). We conclude that biolarviciding received high acceptance among community members in southern Tanzania and therefore the implementation is likely to get strong support from community members. To enhance and make community acceptance sustainable, heath education to enhance the level of community knowledge on biolarviciding is recommended.
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Affiliation(s)
| | | | | | - Eugene Benjamin Meshi
- Department of Community Medicine, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
| | - David Zadock Munisi
- Department of Microbiology and Parasitology, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
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Kamndaya M, Mfipa D, Lungu K. Household knowledge, perceptions and practices of mosquito larval source management for malaria prevention and control in Mwanza district, Malawi: a cross-sectional study. Malar J 2021; 20:150. [PMID: 33731146 PMCID: PMC7967974 DOI: 10.1186/s12936-021-03683-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 03/05/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Mosquito larval source management (LSM) is a key outdoor malaria vector control strategy in rural communities in sub-Saharan Africa. Knowledge of this strategy is important for optimal design and implementation of effective malaria control interventions in this region. This study assessed household knowledge, perceptions and practices of mosquito LSM methods (draining stagnant water, larviciding, clearing grass/bushes and clean environment). METHODS A cross-sectional design was used whereby 479 households were selected using two-stage sampling in Mwanza district, Malawi. A household questionnaire was administered to an adult member of the house. Respondents were asked questions on knowledge, perceptions and practices of mosquito LSM methods. Multivariable logistic regression model was used to identify factors associated with high-level knowledge of mosquito LSM methods. RESULTS Majority of the respondents (64.5%) had high-level knowledge of mosquito LSM methods. Specifically, 63.7% (200/314) had positive perceptions about draining stagnant water, whereas 95.3% (223/234) practiced clean environment for malaria control and 5.2% had knowledge about larviciding. Compared to respondents with primary education, those with secondary education were more likely, whereas those without education were less likely, to have high-level knowledge of mosquito LSM methods (AOR = 3.54, 95% CI 1.45-8.63 and AOR = 0.38, 95% CI 0.23-0.64, respectively). Compared to respondents engaged in crop farming, those engaged in mixed farming (including pastoralists) and the self-employed (including business persons) were more likely to have high-level knowledge of mosquito LSM methods (AOR = 6.95, 95% CI 3.39-14.23 and AOR = 3.61, 95% CI 1.47-8.86, respectively). Respondents living in mud-walled households were less likely to have high-knowledge of mosquito LSM methods than those living in brick-walled households (AOR = 0.50, 95% CI 0.30-0.86). CONCLUSIONS A high-level knowledge of mosquito LSM methods was established. However, when designing and implementing this strategy, specific attention should be paid to the uneducated, crop farmers and those living in poor households.
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Affiliation(s)
- Mphatso Kamndaya
- Department of Mathematics and Statistics, School of Applied Sciences, University of Malawi, The Polytechnic, Private Bag 303, Blantyre 3, Malawi.
| | - Dumisani Mfipa
- Department of Environmental Health, School of Applied Sciences, University of Malawi, The Polytechnic, Private Bag 303, Blantyre 3, Malawi
| | - Kingsley Lungu
- Department of Environmental Health, School of Applied Sciences, University of Malawi, The Polytechnic, Private Bag 303, Blantyre 3, Malawi
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Mapua SA, Finda MF, Nambunga IH, Msugupakulya BJ, Ukio K, Chaki PP, Tripet F, Kelly AH, Christofides N, Lezaun J, Okumu FO. Addressing key gaps in implementation of mosquito larviciding to accelerate malaria vector control in southern Tanzania: results of a stakeholder engagement process in local district councils. Malar J 2021; 20:123. [PMID: 33653355 PMCID: PMC7923449 DOI: 10.1186/s12936-021-03661-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/20/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Larval source management was historically one of the most effective malaria control methods but is now widely deprioritized in Africa, where insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are preferred. However, in Tanzania, following initial successes in urban Dar-es-Salaam starting early-2000s, the government now encourages larviciding in both rural and urban councils nationwide to complement other efforts; and a biolarvicide production-plant has been established outside the commercial capital. This study investigated key obstacles and opportunities relevant to effective rollout of larviciding for malaria control, with a focus on the meso-endemic region of Morogoro, southern Tanzania. METHODS Key-informants were interviewed to assess awareness and perceptions regarding larviciding among designated health officials (malaria focal persons, vector surveillance officers and ward health officers) in nine administrative councils (n = 27). Interviewer-administered questionnaires were used to assess awareness and perceptions of community members in selected areas regarding larviciding (n = 490). Thematic content analysis was done and descriptive statistics used to summarize the findings. RESULTS A majority of malaria control officials had participated in larviciding at least once over the previous three years. A majority of community members had neutral perceptions towards positive aspects of larviciding, but overall support for larviciding was high, although several challenges were expressed, notably: (i) insufficient knowledge for identifying relevant aquatic habitats of malaria vectors and applying larvicides, (ii) inadequate monitoring of programme effectiveness, (iii) limited financing, and (iv) lack of personal protective equipment. Although the key-informants reported sensitizing local communities, most community members were still unaware of larviciding and its potential. CONCLUSIONS The larviciding programme was widely supported by both communities and malaria control officials, but there were gaps in technical knowledge, implementation and public engagement. To improve overall impact, it is important to: (i) intensify training efforts, particularly for identifying habitats of important vectors, (ii) adopt standard technical principles for applying larvicides or larval source management, (iii) improve financing for local implementation and (iv) improve public engagement to boost community awareness and participation. These lessons could also be valuable for other malaria endemic areas wishing to deploy larviciding for malaria control or elimination.
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Affiliation(s)
- Salum A Mapua
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania.
| | - Marceline F Finda
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ismail H Nambunga
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
| | - Betwel J Msugupakulya
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
- School of Life Science and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania
| | - Kusirye Ukio
- President's Office-Regional Administration and Local Government, Morogoro Regional Secretariat, P.O. Box 610, Morogoro, Tanzania
| | - Prosper P Chaki
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
| | - Frederic Tripet
- Centre for Applied Entomology and Parasitology, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
| | - Ann H Kelly
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Nicola Christofides
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Javier Lezaun
- Institute for Science, Innovation and Society, School of Anthropology and Museum Ethnography, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, UK
| | - Fredros O Okumu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- School of Life Science and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania.
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.
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Lupenza ET, Kihonda J, Limwagu AJ, Ngowo HS, Sumaye RD, Lwetoijera DW. Using pastoralist community knowledge to locate and treat dry-season mosquito breeding habitats with pyriproxyfen to control Anopheles gambiae s.l. and Anopheles funestus s.l. in rural Tanzania. Parasitol Res 2021; 120:1193-1202. [PMID: 33409645 DOI: 10.1007/s00436-020-07040-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022]
Abstract
Fundamentally, larviciding with pyriproxyfen (PPF) has potential to complement Long Lasting Insecticide Nets (LLINs) and indoor residual sprays (IRS) in settings where resistance to pyrethroids and residual malaria transmission exist. In this study, we evaluated the field effectiveness of larviciding using PPF to reduce dry season productivity of mosquito breeding habitats that were located by pastoralists within the study area. Using pastoralist knowledge, dry season breeding habitats in Mofu village rural Tanzania were located and monitored for larval productivity for a period of 8 months before PPF intervention. During the intervention, six out of twelve breeding habitats were treated with Sumilarv 0.5G PPF granules. The impact of deposited PPF was monitored by recording emergence inhibition of larvae collected from treated habitats compared to the appropriate control group for a period of three months and half post-intervention. During baseline, the average proportion (+SD) of adult emerged was similar between two clusters, with (0.89 + 0.22) for the control cluster and (0.93 + 0.16) for the treatment cluster of breeding habitats. Following treatment with PPF, the average proportion (+SD) of adult emerged in the treated breeding habitats was significantly low (0.096 + 0.22) compared to adults that emerged from larvae in the untreated habitats (0.99 + 0.22) (p < 0.0001). Of all emerged adults, approximately 94% were An. gambiae s.l. and the remaining 6% were An. funestus s.l. This is the first study demonstrating the usefulness of engaging pastoralist community to locate and identify hard to find mosquito breeding habitats. Reduced productivity of the targeted habitats with PPF offers prospect of implementing PPF larviciding in dry season when habitats are few and permanent to control mosquito population in rural settings.
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Affiliation(s)
- Eliza T Lupenza
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Japhet Kihonda
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Alex J Limwagu
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Halfan S Ngowo
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Robert D Sumaye
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania
| | - Dickson W Lwetoijera
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 53, Ifakara, Tanzania. .,School of Life Science and Bioengineering, Nelson Mandela African Institution of Science & Technology, Arusha, Tanzania.
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11
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Dambach P, Traoré I, Sawadogo H, Zabré P, Shukla S, Sauerborn R, Becker N, Phalkey R. Community acceptance of environmental larviciding against malaria with Bacillus thuringiensis israelensis in rural Burkina Faso - A knowledge, attitudes and practices study. Glob Health Action 2021; 14:1988279. [PMID: 34927578 PMCID: PMC8725727 DOI: 10.1080/16549716.2021.1988279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Malaria control is based on early treatment of cases and on vector control. The current measures for malaria vector control in Africa are mainly based on long-lasting insecticidal nets (LLINs) and to a much smaller extent on indoor residual spraying (IRS). While bed net use is widely distributed and its role is intensively researched, Bti-based larviciding is a relatively novel tool in Africa. In this study, we analyze the perception and acceptability of Bti-based larval source management under different larviciding scenarios that were performed in a health district in Burkina Faso. Objective To research people’s perception and acceptance regarding biological larviciding interventions against malaria in their communities. Methods A cross-sectional study was undertaken using a total of 634 administered questionnaires. Data were collected in a total of 36 rural villages and in seven town quarters of the semi-urban town of Nouna. Results Respondents had basic to good knowledge regarding malaria transmission and how to protect oneself against it. More than 90% reported sleeping under a bed net, while other measures such as mosquito coils and insecticides were only used by a minority. The majority of community members reported high perceived reductions in mosquito abundance and the number of malaria episodes. There was a high willingness to contribute financially to larviciding interventions among interviewees. Conclusions This study showed that biological larviciding interventions are welcomed by the population that they are regarded as an effective and safe means to reduce mosquito abundance and malaria transmission. A routine implementation would, despite low intervention costs, require community ownership and contribution.
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Affiliation(s)
- Peter Dambach
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Issouf Traoré
- Centre De Recherche En Santé De Nouna, Nouna, Burkina Faso.,Institut De Formations Initiale Et Continue, Université Thomas Sankara, Ouagadougou, Burkina Faso
| | | | - Pascal Zabré
- Centre De Recherche En Santé De Nouna, Nouna, Burkina Faso
| | - Sharvari Shukla
- Symbiosis Statistical Institute, Symbiosis International (Deemed University)
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Norbert Becker
- German Mosquito Control Association (KABS), Speyer, Germany.,Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
| | - Revati Phalkey
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.,Epidemiology and Public Health Division, University of Nottingham, Nottingham, UK.,Climate Change and Health Group, Public Health England, Chilton, UK
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12
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Are Individuals Willing to Pay for Community-Based Eco-Friendly Malaria Vector Control Strategies? A Case of Mosquito Larviciding Using Plant-Based Biopesticides in Kenya. SUSTAINABILITY 2020. [DOI: 10.3390/su12208552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study was carried out to assess individuals’ willingness to pay (WTP) for UZIMAX, a novel plant-based biopesticide developed for malaria vector control. The biopesticide is estimated to kill up to 100% of Anopheles larvae within 48 h of application and poses no risks to human health and the environment. However, scaling-up of its adoption requires clear evidence of its acceptance by individuals in malaria-prone areas. We conducted Becker-DeGroot-Marschak (BDM) revealed preference auctions with 204 participants to determine their willingness to pay (WTP) for community-based application of the biopesticide to control malaria vectors. Nearly all participants were willing to pay at the lowest bid price of the biopesticide, and the majority of them expressed great interest in pooling resources to facilitate biopesticide application. Household per capita income and building capacity of households through training significantly increased WTP. These findings imply high adoption potential of the technology and the need to devise inclusive policy tools, especially those that enhance collective action, resource mobilization and capacity building to empower both men and women and stimulate investment in eco-friendly technologies for malaria prevention. Financial and labor resource mechanisms managed by the community could potentially spur adoption of the biopesticides, and in turn, generate health, environmental and economic benefits to households in malaria-prone communities.
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13
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Berlin Rubin N, Mboera LE, Lesser A, Miranda ML, Kramer R. Process Evaluation of a Community-Based Microbial Larviciding Intervention for Malaria Control in Rural Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7309. [PMID: 33036350 PMCID: PMC7579308 DOI: 10.3390/ijerph17197309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 11/16/2022]
Abstract
Microbial larviciding can be an effective component of integrated vector management malaria control schemes, although it is not commonly implemented. Moreover, quality control and evaluation of intervention activities are essential to evaluate the potential of community-based larviciding interventions. We conducted a process evaluation of a larval source management intervention in rural Tanzania where local staff were employed to apply microbial larvicide to mosquito breeding habitats with the aim of long-term reductions in malaria transmission. We developed a logic model to guide the process evaluation and then established quantitative indicators to measure intervention success. Quantitative analysis of intervention reach, exposure, and fidelity was performed to assess larvicide application, and interviews with larviciding staff were reviewed to provide context to quantitative results. Results indicate that the intervention was successful in terms of reach, as staff applied microbial larvicide at 80% of identified mosquito breeding habitats. However, the dosage of larvicide applied was sufficient to ensure larval elimination at only 26% of sites, which does not meet the standard set for intervention fidelity. We propose that insufficient training and protocol adaptation, environment and resource issues, and human error contributed to low larvicide application rates. This demonstrates how several small, context-specific details in sum can result in meaningful differences between intervention blueprint and execution. These findings may serve the design of other larval source management interventions by demonstrating the value of additional training, supervision, and measurement and evaluation of protocol adherence.
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Affiliation(s)
- Nina Berlin Rubin
- Department of Earth System Science, Stanford University, Stanford, CA 94305, USA
| | - Leonard E.G. Mboera
- SACIDS Foundation for One Health, Sokoine University of Agriculture, 3297 Morogoro, Tanzania;
| | - Adriane Lesser
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA; (A.L.); (R.K.)
| | - Marie Lynn Miranda
- Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, IN 46556, USA;
| | - Randall Kramer
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA; (A.L.); (R.K.)
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14
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Jumbam DT, Stevenson JC, Matoba J, Grieco JP, Ahern LN, Hamainza B, Sikaala CH, Chanda-Kapata P, Cardol EI, Munachoonga P, Achee NL. Knowledge, attitudes and practices assessment of malaria interventions in rural Zambia. BMC Public Health 2020; 20:216. [PMID: 32050923 PMCID: PMC7017631 DOI: 10.1186/s12889-020-8235-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 01/16/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Despite rapid upscale of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), malaria remains a major source of morbidity and mortality in Zambia. Uptake and utilization of these and novel interventions are often affected by knowledge, attitudes and practices (KAP) amongst persons living in malaria-endemic areas. The aims of this study were to assess malaria KAP of primary caregivers and explore trends in relation to ITN use, IRS acceptance and mosquito density in two endemic communities in Luangwa and Nyimba districts, Zambia. METHODS A cohort of 75 primary caregivers were assessed using a cross-sectional, forced-choice malaria KAP survey on ITN use, IRS acceptance and initial perception of a novel spatial repellent (SR) product under investigation. Entomological sampling was performed in participant homes using CDC Miniature Light Traps to relate indoor mosquito density with participant responses. RESULTS Ninety-nine percent of participants cited bites of infected mosquitoes as the route of malaria transmission although other routes were also reported including drinking dirty water (64%) and eating contaminated food (63%). All caregivers agreed that malaria was a life-threatening disease with the majority of caregivers having received malaria information from health centers (86%) and community health workers (51%). Cumulatively, self-reported mosquito net use was 67%. Respondents reportedly liked the SR prototype product but improvements on color, shape and size were suggested. Overall, 398 mosquitoes were captured from light-trap collections, including 49 anophelines and 349 culicines. Insecticide treated nets use was higher in households from which at least one mosquito was captured. CONCLUSIONS The current study identified misconceptions in malaria transmission among primary caregivers indicating remaining knowledge gaps in educational campaigns. Participant responses also indicated a misalignment between a low perception of IRS efficacy and high stated acceptance of IRS, which should be further examined to better understand uptake and sustainability of other vector control strategies. While ITNs were found to be used in study households, misperceptions between presence of mosquitoes and bite protection practices did exist. This study highlights the importance of knowledge attitudes and practice surveys, with integration of entomological sampling, to better guide malaria vector control product development, strategy acceptance and compliance within endemic communities.
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Affiliation(s)
- Desmond T. Jumbam
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Indiana, USA
| | - Jennifer C. Stevenson
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Macha Research Trust, Choma, Zambia
| | | | - John P. Grieco
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Indiana, USA
| | - Lacey N. Ahern
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Indiana, USA
| | - Busiku Hamainza
- National Malaria Control Centre, Ministry of Health, Lusaka, Zambia
| | | | | | - Esther I. Cardol
- Macha Research Trust, Choma, Zambia
- Radboud University, Nijmegen, Netherlands
| | | | - Nicole L. Achee
- Department of Biological Sciences, Eck Institute for Global Health, University of Notre Dame, Indiana, USA
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15
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Derua YA, Kweka EJ, Kisinza WN, Githeko AK, Mosha FW. Bacterial larvicides used for malaria vector control in sub-Saharan Africa: review of their effectiveness and operational feasibility. Parasit Vectors 2019; 12:426. [PMID: 31470885 PMCID: PMC6716942 DOI: 10.1186/s13071-019-3683-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 08/23/2019] [Indexed: 12/19/2022] Open
Abstract
Several trials and reviews have outlined the potential role of larviciding for malaria control in sub-Saharan Africa (SSA) to supplement the core indoor insecticide-based interventions. It has been argued that widespread use of long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) interventions in many parts of Africa result in many new areas with low and focal malaria transmission that can be targeted with larvicides. As some countries in SSA are making good progress in malaria control, larval source management, particularly with bacterial larvicides, could be included in the list of viable options to maintain the gains achieved while paving the way to malaria elimination. We conducted a review of published literature that investigated the application of bacterial larvicides, Bacillus thuringiensis var. israelensis (Bti) and/or Bacillus sphaericus (Bs) for malaria vector control in SSA. Data for the review were identified through PubMed, the extensive files of the authors and reference lists of relevant articles retrieved. A total of 56 relevant studies were identified and included in the review. The findings indicated that, at low application rates, bacterial larvicide products based on Bti and/or Bs were effective in controlling malaria vectors. The larvicide interventions were found to be feasible, accepted by the general community, safe to the non-target organisms and the costs compared fairly well with those of other vector control measures practiced in SSA. Our review suggests that larviciding should gain more ground as a tool for integrated malaria vector control due to the decline in malaria which creates more appropriate conditions for the intervention and to the recognition of limitations of insecticide-based vector control tools. The advancement of new technology for mapping landscapes and environments could moreover facilitate identification and targeting of the numerous larval habitats preferred by the African malaria vectors. To build sustainable anti-larval measures in SSA, there is a great need to build capacity in relevant specialties and develop organizational structures for governance and management of larval source management programmes.
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Affiliation(s)
- Yahya A Derua
- Kilimanjaro Christian Medical University College, Tumaini University Makumira, Moshi, Tanzania. .,National Institute for Medical Research, Amani Research Centre, Muheza, Tanga, Tanzania.
| | - Eliningaya J Kweka
- Division of Livestock and Human Diseases Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania.,Department of Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - William N Kisinza
- National Institute for Medical Research, Amani Research Centre, Muheza, Tanga, Tanzania
| | - Andrew K Githeko
- Climate and Human Health Research Unit, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Franklin W Mosha
- Kilimanjaro Christian Medical University College, Tumaini University Makumira, Moshi, Tanzania
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16
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Mazigo HD, Massawe IS, Rumisha SF, Kweka EJ, Mboera LEG. Rice farmers' perceptions and acceptability in the use of a combination of biolarvicide (Bacillus thuringiensis var. israeliensis) and fertilizers application for malaria control and increase rice productivity in a rural district of central Tanzania. Malar J 2019; 18:71. [PMID: 30866945 PMCID: PMC6416922 DOI: 10.1186/s12936-019-2697-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/01/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The use of larval source management as a supplementary intervention for malaria control has not been widely used in rural Africa due to perceived high costs and complex logistics. To reduce the cost of larviciding in rice farming communities, concurrent application of biolarvicides and fertilizer in rice fields was introduced to control malaria vectors larvae and improve rice grain yields. The present study determined rice farmers' perceptions and acceptability in the use of a combination of biolarvicide and fertilizers in farming practices. METHODS This was a qualitative study conducted among rice farmers at Kilangali village, south-central Tanzania. Semi-structured interviews and three focus group discussions (FGDs) were conducted with men and women who participated in the biolarvicide and fertilizer application project. The interviews and discussion focused on knowledge, attitudes and perceptions of participants on the use of the innovation in their farming practices and their willingness to pay for the innovation. RESULTS A total of 40 (mean age = 38.8 ± 10.12 years) rice farmers were involved in the study. Overall, all farmers agreed that it was possible to apply the two products concurrently with minimal challenges. The trust on the safety of biolarvicides on both human and paddy health was high. Respondents reported no challenge in preparation and applying the product in their rice fields. Over half (56.6%) of the participants reported an average decrease in mosquito density in their households and a quarter (26.6%) of them reported a decrease in mosquito population in their farms. Similarly, 93.3% of the participants reported that the intervention had reduced malaria risk in their households. In general, all participants expressed willingness to contribute to a biolarvicide and fertilizer programme and to use the approach in their farming practices. CONCLUSION Community-based concurrent application of biolarvicides and fertilizer in rice fields was feasible and led to a perceived reduction in mosquito density. Willingness to pay for the larviciding/fertilizer approach was expressed by participants and they accepted to use the approach in their future farming practices. However, the impact of this approach on malaria transmission and rice grain harvest need to be evaluated in a large-scale programme.
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Affiliation(s)
- Humphrey D Mazigo
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1462, Mwanza, Tanzania.
| | - Isolide S Massawe
- National Institute for Medical Research, Tanga Research Center, Tanga, Tanzania
| | - Susan F Rumisha
- National Institute for Medical Research Headquarters, Dar es Salaam, Tanzania
| | - Eliningaya J Kweka
- Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1462, Mwanza, Tanzania
- Tropical Pesticides Research Institute, P.O. Box 3024, Arusha, Tanzania
| | - Leonard E G Mboera
- National Institute for Medical Research Headquarters, Dar es Salaam, Tanzania
- Southern African Centre for Infectious Diseases Surveillance, Chuo Kikuu cha Kilimo, Sokoine, Morogoro, Tanzania
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17
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Sense of community and willingness to support malaria intervention programme in urban poor Accra, Ghana. Malar J 2018; 17:289. [PMID: 30097021 PMCID: PMC6086070 DOI: 10.1186/s12936-018-2424-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/21/2018] [Indexed: 11/10/2022] Open
Abstract
Background The extensive research on community members’ willingness to support malaria interventions ignores the role of psychosocial determinants. This study assesses the impact of individuals’ sense of community (perceptions of community cohesion, altruism, seeking help from neighbours and migrant status) on their willingness to participate in a mosquito control programme using data on 768 individuals from the 2013 RIPS Urban Health and Poverty Survey in poor coastal communities in Accra, Ghana. A contingent valuation experiment was employed to elicit individuals’ willingness to support the programme by contributing nothing, labour time/money only or both. Results Findings show that different dimensions of sense of community related differently with willingness to support the programme. Perceived community cohesion was associated with lower odds while help-seeking from neighbours and being a migrant were associated with higher odds of supporting the programme. Altruism was the only dimension not linked to willingness to participate. Conclusions Different dimensions of sense of community are associated with community members’ willingness to provide labour, time or both to support the malaria eradication programme. The findings of this study have implications for targeting social relational aspects, in addition to geographical aspects, of communities with malaria-resilient policy and intervention. They also warrant further research on psychosocial factors that predict willingness to support health programmes in urban poor settings.
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18
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A qualitative study of community perception and acceptance of biological larviciding for malaria mosquito control in rural Burkina Faso. BMC Public Health 2018; 18:399. [PMID: 29566754 PMCID: PMC5865284 DOI: 10.1186/s12889-018-5299-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/12/2018] [Indexed: 12/02/2022] Open
Abstract
Background Vector and malaria parasite’s rising resistance against pyrethroid-impregnated bed nets and antimalarial drugs highlight the need for additional control measures. Larviciding against malaria vectors is experiencing a renaissance with the availability of environmentally friendly and target species-specific larvicides. In this study, we analyse the perception and acceptability of spraying surface water collections with the biological larvicide Bacillus thuringiensis israelensis in a single health district in Burkina Faso. Methods A total of 12 focus group discussions and 12 key informant interviews were performed in 10 rural villages provided with coverage of various larvicide treatments (all breeding sites treated, the most productive breeding sites treated, and untreated control). Results Respondents’ knowledge about the major risk factors for malaria transmission was generally good. Most interviewees stated they performed personal protective measures against vector mosquitoes including the use of bed nets and sometimes mosquito coils and traditional repellents. The acceptance of larviciding in and around the villages was high and the majority of respondents reported a relief in mosquito nuisance and malarial episodes. There was high interest in the project and demand for future continuation. Conclusion This study showed that larviciding interventions received positive resonance from the population. People showed a willingness to be involved and financially support the program. The positive environment with high acceptance for larviciding programs would facilitate routine implementation. An essential factor for the future success of such programs would be inclusion in regional or national malaria control guidelines. Electronic supplementary material The online version of this article (10.1186/s12889-018-5299-7) contains supplementary material, which is available to authorized users.
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19
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Ingabire CM, Hakizimana E, Rulisa A, Kateera F, Van Den Borne B, Muvunyi CM, Mutesa L, Van Vugt M, Koenraadt CJM, Takken W, Alaii J. Community-based biological control of malaria mosquitoes using Bacillus thuringiensis var. israelensis (Bti) in Rwanda: community awareness, acceptance and participation. Malar J 2017; 16:399. [PMID: 28974204 PMCID: PMC5627396 DOI: 10.1186/s12936-017-2046-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 09/26/2017] [Indexed: 12/04/2022] Open
Abstract
Background Targeting the aquatic stages of malaria vectors via larval source management (LSM) in collaboration with local communities could accelerate progress towards malaria elimination when deployed in addition to existing vector control strategies. However, the precise role that communities can assume in implementing such an intervention has not been fully investigated. This study investigated community awareness, acceptance and participation in a study that incorporated the socio-economic and entomological impact of LSM using Bacillus thuringiensis var. israelensis (Bti) in eastern Rwanda, and identified challenges and recommendations for future scale-up. Methods The implementation of the community-based LSM intervention took place in Ruhuha, Rwanda, from February to July 2015. The intervention included three arms: control, community-based (CB) and project-supervised (PS). Mixed methods were used to collect baseline and endline socio-economic data in January and October 2015. Results A high perceived safety and effectiveness of Bti was reported at the start of the intervention. Being aware of malaria symptoms and perceiving Bti as safe on other living organisms increased the likelihood of community participation through investment of labour time for Bti application. On the other hand, the likelihood for community participation was lower if respondents: (1) perceived rice farming as very profitable; (2) provided more money to the cooperative as a capital; and, (3) were already involved in rice farming for more than 6 years. After 6 months of implementation, an increase in knowledge and skills regarding Bti application was reported. The community perceived a reduction in mosquito density and nuisance biting on treated arms. Main operational, seasonal and geographical challenges included manual application of Bti, long working hours, and need for transportation for reaching the fields. Recommendations were made for future scale-up, including addressing above-mentioned concerns and government adoption of LSM as part of its vector control strategies. Conclusions Community awareness and support for LSM increased following Bti application. A high effectiveness of Bti in terms of reduction of mosquito abundance and nuisance biting was perceived. The study confirmed the feasibility of community-based LSM interventions and served as evidence for future scale-up of Bti application and adoption into Rwandan malaria vector control strategies.
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Affiliation(s)
- Chantal Marie Ingabire
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands. .,Medical Research Center, Rwanda Biomedical Center, Kigali, Rwanda.
| | - Emmanuel Hakizimana
- Malaria & Other Parasitic Diseases Division, Rwanda Biomedical Center, Kigali, Rwanda.,Laboratory of Entomology, Wageningen University, Wageningen, The Netherlands
| | - Alexis Rulisa
- Medical Research Center, Rwanda Biomedical Center, Kigali, Rwanda.,Department of Cultural Anthropology and Development Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Fredrick Kateera
- Medical Research Center, Rwanda Biomedical Center, Kigali, Rwanda.,Academic Medical Center, Amsterdam, The Netherlands
| | - Bart Van Den Borne
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | | | - Leon Mutesa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | - Willem Takken
- Laboratory of Entomology, Wageningen University, Wageningen, The Netherlands
| | - Jane Alaii
- Context Factor Solutions, Nairobi, Kenya
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20
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Rahman R, Lesser A, Mboera L, Kramer R. Cost of microbial larviciding for malaria control in rural Tanzania. Trop Med Int Health 2016; 21:1468-1475. [PMID: 27500959 DOI: 10.1111/tmi.12767] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Microbial larviciding may be a potential supplement to conventional malaria vector control measures, but scant information on its relative implementation costs and effectiveness, especially in rural areas, is an impediment to expanding its uptake. We perform a costing analysis of a seasonal microbial larviciding programme in rural Tanzania. METHODS We evaluated the financial and economic costs from the perspective of the public provider of a 3-month, community-based larviciding intervention implemented in twelve villages in the Mvomero District of Tanzania in 2012-2013. Cost data were collected from financial reports and invoices and through discussion with programme administrators. Sensitivity analysis explored the robustness of our results to varying key parameters. RESULTS Over the 2-year study period, approximately 6873 breeding sites were treated with larvicide. The average annual economic costs of the larviciding intervention in rural Tanzania are estimated at 2014 US$ 1.44 per person protected per year (pppy), US$ 6.18 per household and US$ 4481.88 per village, with the larvicide and staffing accounting for 14% and 58% of total costs, respectively. CONCLUSIONS We found the costs pppy of implementing a seasonal larviciding programme in rural Tanzania to be comparable to the costs of other larviciding programmes in urban Tanzania and rural Kenya. Further research should evaluate the cost-effectiveness of larviciding relative to, and in combination with, other vector control strategies in rural settings.
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Affiliation(s)
- Rifat Rahman
- Duke Global Health Institute, Duke University, Durham, NC, USA.
| | - Adriane Lesser
- Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Leonard Mboera
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Randall Kramer
- Duke Global Health Institute, Duke University, Durham, NC, USA.,Nicholas School of the Environment, Duke University, Durham, NC, USA
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