Determinants of the use of insecticide-treated bed nets on islands of pre- and post-malaria elimination: an application of the health belief model in Vanuatu.
Determinants of the use of insecticide-treated bed nets on islands of pre- and post-malaria elimination: an application of the health belief model in Vanuatu.
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DOI：
10.1186/1475-2875-13-441
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发表时间：
2014-11-20
期刊：
影响因子：
3
通讯作者：
Larson PS
中科院分区：
文献类型：
--
作者：
Watanabe N;Kaneko A;Yamar S;Leodoro H;Taleo G;Tanihata T;Lum JK;Larson PS
经杀虫剂处理的蚊帐 (ITN) 是任何疟疾消除战略的一个组成部分，但合规性仍然是一个挑战，而且使用的决定因素因地点和环境而异。健康信念模型 (HBM) 是一个探索对疟疾和驱虫蚊帐 (ITN) 使用的看法和信念的工具。该模型的见解可用于扩大覆盖范围，以控制岛屿上的疟疾传播。 2012 年 7 月，在瓦努阿图的两个岛屿上开展了一项由问卷调查和访谈组成的混合方法研究：安巴岛（Ambae Island）和阿内尤姆岛（Aneityum Island），前者疟疾传播仍处于低水平，后者于 1991 年启动的消除计划已使传播停止数年。对于大多数 HBM 构建，两个岛屿之间的结果没有发现显着差异：对疟疾的恐惧 (99%)、疟疾的严重程度 (55%)、使用驱虫蚊帐 (ITN) 的疟疾预防益处 (79%) 以及使用驱虫蚊帐 (ITN) 的意愿 (93%)。前一天晚上 Aneityum 上的 ITN 使用率 (73%) 高于 Ambae 上的使用率 (68%)，但没有统计学意义。访谈和小组讨论的结果显示，Ambae 的参与者倾向于认为，由于认为不存在疟疾，因此风险较低，而 Aneityum 的参与者则认为，尽管长期以来没有疟疾，但他们仍然面临风险。在这两个岛屿上，感知风险、热不适、更换蚊帐的成本、缺钱、缺乏蚊帐、蚊帐状况不佳以及悬挂不便等方面的季节性变化产生了负面影响，而通过宣传活动进行的免费群众分发和疟疾预防福利则对杀虫剂蚊帐的使用产生了积极影响。 Ambae 的结果凸显了在传播持续发生时激励社区参与消除疟疾工作所面临的挑战，而 Aneityum 的结果表明，鉴于疟疾卷土重来的威胁，继续遵守疟疾消除工作的可能性。如果社区能够高度参与，消除疟疾计划就可能取得成功。本文的在线版本 (doi:10.1186/1475-2875-13-441) 包含补充材料，可供授权用户使用。
Insecticide-treated nets (ITNs) are an integral piece of any malaria elimination strategy, but compliance remains a challenge and determinants of use vary by location and context. The Health Belief Model (HBM) is a tool to explore perceptions and beliefs about malaria and ITN use. Insights from the model can be used to increase coverage to control malaria transmission in island contexts. A mixed methods study consisting of a questionnaire and interviews was carried out in July 2012 on two islands of Vanuatu: Ambae Island where malaria transmission continues to occur at low levels, and Aneityum Island, where an elimination programme initiated in 1991 has halted transmission for several years. For most HBM constructs, no significant difference was found in the findings between the two islands: the fear of malaria (99%), severity of malaria (55%), malaria-prevention benefits of ITN use (79%) and willingness to use ITNs (93%). ITN use the previous night on Aneityum (73%) was higher than that on Ambae (68%) though not statistically significant. Results from interviews and group discussions showed that participants on Ambae tended to believe that risk was low due to the perceived absence of malaria, while participants on Aneityum believed that they were still at risk despite the long absence of malaria. On both islands, seasonal variation in perceived risk, thermal discomfort, costs of replacing nets, a lack of money, a lack of nets, nets in poor condition and the inconvenience of hanging had negative influences, while free mass distribution with awareness campaigns and the malaria-prevention benefits had positive influences on ITN use. The results on Ambae highlight the challenges of motivating communities to engage in elimination efforts when transmission continues to occur, while the results from Aneityum suggest the possibility of continued compliance to malaria elimination efforts given the threat of resurgence. Where a high degree of community engagement is possible, malaria elimination programmes may prove successful. The online version of this article (doi:10.1186/1475-2875-13-441) contains supplementary material, which is available to authorized users.
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