Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
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DOI：
10.1186/s12936-017-2056-9
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发表时间：
2017-10-11
期刊：
影响因子：
3
通讯作者：
Jones, Caroline
中科院分区：
文献类型：
--
作者：
Makungu, Christina;Stephen, Stephania;Jones, Caroline
背景资料：使用长效驱虫蚊帐和室内滞留喷洒预防疟疾的效果受到以下因素的限制：杀虫剂抗药性的出现、蚊子的躲避行为，包括室外叮咬、执行工作欠佳以及使用不当。新的病媒控制干预措施是必要的，其潜在的有效性将得到加强，如果现有的家庭观念和做法纳入干预design.Methods：本定性描述性研究采用焦点小组讨论，深入访谈和photovoice方法，探讨在坦桑尼亚达累斯萨拉姆的四个研究地点的居民之间的蚊子控制的观念和做法。蚊子被认为是一个日益严重的问题，这直接归因于广泛的环境恶化和缺乏有效的蚊子控制干预措施。疟疾和叮咬被认为是蚊子造成的主要问题。繁殖地与休息地有明显区别，但居民并没有区分产生疟疾病媒蚊子的栖息地和其他主要产生滋扰蚊子的栖息地。在最富裕的地区，最常提到的保护方法是蚊帐、喷雾杀虫剂、纱窗和熏蒸，而在最不富裕的地区，蚊帐被最常提到并被描述为“文化的一部分”。防蚊的住房一直被认为是可取的，但被认为是负担不起的最富裕的地区以外。拍打和用衣服覆盖是最常用的防止在户外咬人的方法。尽管它们在户外有用，但应用于皮肤的局部驱虫剂被认为是昂贵的，并且由于可感知的副作用而被怀疑。改善当地环境是预防户外叮咬的首选方法。负担能力，有效性，可用性，实用性，以及社会影响，如政府的建议，社会化和内化（熟悉和习惯）被描述为影响uptake.Conclusions的关键因素：户外传播被广泛接受为消除疟疾的障碍。针对疟疾病媒和叮咬害虫的蚊子的幼虫来源管理是达累斯萨拉姆居民控制蚊子的首选方法，应与户外个人防护新方法一起优先开发。即使这些额外的干预措施可以提供、有效和负担得起，也可能需要时间和用户经验才能获得积极的声誉和可信度。
Background: The effectiveness of malaria prevention with long-lasting insecticidal nets and indoor residual spraying is limited by emerging insecticide resistance, evasive mosquito behaviours that include outdoor biting, sub-optimal implementation and inappropriate use. New vector control interventions are required and their potential effectiveness will be enhanced if existing household perceptions and practices are integrated into intervention design.Methods: This qualitative descriptive study used focus groups discussions, in-depth interviews and photovoice methods to explore mosquito control perceptions and practices among residents in four study sites in Dar es Salaam, Tanzania.Results: Mosquitoes were perceived as a growing problem, directly attributed to widespread environmental deterioration and lack of effective mosquito control interventions. Malaria and nuisance biting were perceived as the main problem caused by mosquitoes. Breeding sites were clearly distinguished from resting sites but residents did not differentiate between habitats producing malaria vector mosquitoes and others producing mostly nuisance mosquitoes. The most frequently mentioned protection methods in the wealthiest locations were bed nets, aerosol insecticide sprays, window screens, and fumigation, while bed nets were most frequently mentioned and described as 'part of the culture' in the least wealthy locations. Mosquito-proofed housing was consistently viewed as desirable, but considered unaffordable outside wealthiest locations. Slapping and covering up with clothing were most commonly used to prevent biting outdoors. Despite their utility outdoors, topical repellents applied to the skin were considered expensive, and viewed with suspicion due to perceived side effects. Improving the local environment was the preferred method for preventing outdoor biting. Affordability, effectiveness, availability, practicality, as well as social influences, such as government recommendations, socialization and internalization (familiarization and habit) were described as key factors influencing uptake.Conclusions: Outdoor transmission is widely accepted as an obstacle to malaria elimination. Larval source management, targeting both malaria vectors and nuisance-biting mosquitoes, is the preferred method for mosquito control among the residents of Dar es Salaam and should be prioritized for development alongside new methods for outdoor personal protection. Even if made available, effective and affordable, these additional interventions may require time and user experience to achieve positive reputations and trustworthiness.