Social and cultural factors affecting rates of regular retreatment of mosquito nets with insecticide in Bagamoyo District, Tanzania
Social and cultural factors affecting rates of regular retreatment of mosquito nets with insecticide in Bagamoyo District, Tanzania
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DOI：
10.1046/j.1365-3156.1997.d01-376.x
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发表时间：
1997-08-01
影响因子：
3.3
通讯作者：
Shiff, CJ
中科院分区：
文献类型：
--
作者：
Winch, PJ;Makemba, AM;Shiff, CJ
经杀虫剂处理的蚊帐对在受控条件下患病的幼儿的死亡率和发病率有影响。当被纳入更大的控制计划时，定期用杀虫剂重新处理蚊帐的比例可能会下降，这极大地限制了它们作为公共卫生干预措施的有效性。在坦桑尼亚的巴加莫约区，在开始支付杀虫剂费用后，再治疗率大幅下降，在所有研究村庄举行了一系列邻里（哈姆雷特）会议，讨论人们对杀虫剂的关切以及提高再治疗率的方法。虽然对重新治疗的程序作了修改，但重新治疗的比率仍然低于预期，而且在村庄内部和村庄之间有明显的差异。然后，我们进行了非结构化的关键知情人访谈，以及在一个村庄的非正式讨论与强大的变化之间的不同部门的村庄的再治疗率。虽然后勤问题最常被认为是不带蚊帐进行再治疗的原因，但社区内的政治和社会分歧提供了更好的解释。这是证明了低响应重新安排的物流，使撤退的蚊帐显着更容易为家庭，和较高的响应时，作出了改变，在沟通渠道以及物流功能。显然，村民们更难体会到杀虫剂的好处，而不是蚊帐的好处。任何大规模方案要想可持续，就必须从一开始就高度重视杀虫剂及其有益效果。
Insecticide-treated mosquito nets have an impact on mortality and morbidity ill young children under controlled conditions. When integrated into larger control programs, there is the danger chat rates of regular retreatment of the nets with insecticide will drop, greatly limiting their effectiveness as a public health intervention. In Bagamoyo District, Tanzania, rates of retreatment dropped significantly when payment for the insecticide was introduced, A series of neighbourhood (hamlet) meetings were held in all study villages to discuss people's concerns about the insecticide and ways to increase rates of retreatment. Although changes were made in the procedure for retreatment, rates of retreatment remained lower than expected and showed marked variation within as well as between villages. We then conducted unstructured key informant interviews as well as informal discussions in a village with strong variation between different sectors of the village in rates of retreatment. While logistical problems were most frequently cited as reasons not to bring nets for retreatment, political and social divisions within the community provided a better explanation. This is borne out by the low response to rearrangements in logistics which made retreating the nets significantly easier for households, and the higher response when changes were made in the channels of communication as well as the logistic features. It is clearly more difficult for villagers to appreciate the benefits of the insecticide than those of the nets. Great emphasis needs to be placed on the insecticide and its beneficial effects from the outset for any large-scale programme to be sustainable.