Forest work and its implications for malaria elimination: a qualitative study
Forest work and its implications for malaria elimination: a qualitative study
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DOI：
10.1186/s12936-019-3008-3
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发表时间：
2019-11-27
期刊：
影响因子：
3
通讯作者：
Pell, Christopher
中科院分区：
文献类型：
--
作者：
Sanann, Nou;Peto, Thomas J.;Pell, Christopher
背景在过去的20年里，大湄公河次区域（GMS）的疟疾发病率有所下降，青蒿素耐药性的出现刺激了加快区域消除疟疾的努力。在大湄公河次区域，疟疾传播越来越集中在森林地区。本文介绍了森林的活动，并探讨了森林工作者的态度和经验，疟疾预防和控制在东北部Cambodia.MethodsIn上丁省，柬埔寨，19个深入的访谈进行了村庄与参与者最近被诊断为简单的恶性疟谁报告在森林工作。与答卷人的林业同行举行了两次重点小组讨论。访谈和重点小组录音转录，并翻译专题分析。ResultsForest工作是受访者的一个重要收入来源。许多联合收割机将它与农业结合起来，这影响了森林访问的时间和持续时间。森林活动包括伐木和采集其他森林产品，特别是锦葵果。男子全年伐木，而采集森林产品则是季节性的，可能涉及整个家庭。林业工人主要睡在临时营地的未浸渍吊床网中。受访者关注有症状的疟疾，但不熟悉无症状感染者的概念。他们认为森林是一个潜在的疟疾感染区，并试图通过穿长袖衣服、使用驱虫剂和生火来保护自己免受蚊子叮咬。森林工人表示愿意自我测试和自我管理anti-malarials.ConclusionsForest工人的行为和风险的看法表明，需要改进目前的控制措施。有可能：更好地有针对性地分发浸渍吊床蚊帐;在森林中提供治疗或推定治疗;扩大筛查的范围。确定大湄公河次区域森林工人预防的有效性和可行性是一个优先事项。
BackgroundOver the last 20 years, malaria incidence has decreased across the Greater Mekong Sub-region (GMS) and the emergence of artemisinin resistance has stimulated efforts to accelerate regional elimination. In the GMS, the malaria transmission is focused increasingly in forested zones. This article describes forest-going activities and examines forest workers' attitudes to and experiences of malaria prevention and control in north-eastern Cambodia.MethodsIn Stung Treng Province, Cambodia, 19 in-depth interviews were conducted in villages with participants recently diagnosed with uncomplicated falciparum malaria who reported working in forests. Two focus group discussions with respondents' forest-working peers were held. Interviews and focus groups were audio-recorded transcribed, and translated for thematic analysis.ResultsForest work is an essential source of income for respondents. Many combine it with farming, which influences the timing and duration of forest visits. Forest activities include logging and collecting other forest products, particularly malva nuts. Men log year-round, whereas gathering forest products is seasonal and can involve entire families. Forest workers sleep chiefly in unimpregnated hammock nets in make-shift encampments. Respondents are concerned about symptomatic malaria, but unfamiliar with the concept of asymptomatic infection. They view the forest as an area of potential malaria infection and seek to protect themselves from mosquito bites through wearing long-sleeved clothes, using repellents, and lighting fires. Forest workers express a willingness to self-test and self-administer anti-malarials.ConclusionsForest workers' behaviour and perceptions of risk indicate that improvements are needed to current control measures. There is potential to: better target distribution of impregnated hammock nets; offer curative or presumptive treatment while in forests; and expand access to screening. Establishing the efficacy and feasibility of prophylaxis for forest workers in the GMS is a priority.