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Liheluka EA, Massawe IS, Chiduo MG, Mandara CI, Chacky F, Ndekuka L, Temba FF, Mmbando BP, Seth MD, Challe DP, Makunde WH, Mhina AD, Baraka V, Segeja MD, Derua YA, Batengana BM, Hayuma PM, Madebe RA, Malimi MC, Mandike R, Mkude S, Molteni F, Njau R, Mohamed A, Rumisha SF, Ishengoma DS. Community knowledge, attitude, practices and beliefs associated with persistence of malaria transmission in North-western and Southern regions of Tanzania. Malar J 2023; 22:304. [PMID: 37817185 PMCID: PMC10563328 DOI: 10.1186/s12936-023-04738-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Despite significant decline in the past two decades, malaria is still a major public health concern in Tanzania; with over 93% of the population still at risk. Community knowledge, attitudes and practices (KAP), and beliefs are key in enhancing uptake and utilization of malaria control interventions, but there is a lack of information on their contribution to effective control of the disease. This study was undertaken to determine KAP and beliefs of community members and service providers on malaria, and how they might be associated with increased risk and persistence of the disease burden in North-western and Southern regions of Tanzania. METHODS This was an exploratory study that used qualitative methods including 16 in-depth interviews (IDI) and 32 focus group discussions (FGDs) to collect data from health service providers and community members, respectively. The study was conducted from September to October 2017 and covered 16 villages within eight districts from four regions of mainland Tanzania (Geita, Kigoma, Mtwara and Ruvuma) with persistently high malaria transmission for more than two decades. RESULTS Most of the participants had good knowledge of malaria and how it is transmitted but some FGD participants did not know the actual cause of malaria, and thought that it is caused by bathing and drinking un-boiled water, or consuming contaminated food that has malaria parasites without warming it. Reported barriers to malaria prevention and control (by FGD and IDI participants) included shortage of qualified health workers, inefficient health financing, low care-seeking behaviour, consulting traditional healers, use of local herbs to treat malaria, poverty, increased breeding sites by socio-economic activities and misconceptions related to the use of bed nets and indoor residual spraying (IRS). Among the misconceptions, some participants believed that bed nets provided for free by the government came with bedbugs while others reported that free bed nets caused impotence among men. CONCLUSION Despite good knowledge of malaria, several risk factors, such as socio-economic and behavioural issues, and misconceptions related to the use of bed nets and IRS were reported. Other key factors included unavailability or limited access to health services, poor health financing and economic activities that potentially contributed to persistence of malaria burden in these regions. Relevant policies and targeted malaria interventions, focusing on understanding socio-cultural factors, should be implemented to reduce and finally eliminate the disease in the study regions and others with persistent transmission.
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Affiliation(s)
| | | | - Mercy G Chiduo
- National Institute for Medical Research, Tanga, Tanzania
| | - Celine I Mandara
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Frank Chacky
- National Malaria Control Programme, Dodoma, Tanzania
| | - Leah Ndekuka
- National Malaria Control Programme, Dodoma, Tanzania
| | | | | | - Misago D Seth
- National Institute for Medical Research, Tanga, Tanzania
| | | | | | | | - Vito Baraka
- National Institute for Medical Research, Tanga, Tanzania
| | | | - Yahya A Derua
- National Institute for Medical Research, Amani Medical Research Centre, Tanga, Tanzania
| | - Bernard M Batengana
- National Institute for Medical Research, Amani Medical Research Centre, Tanga, Tanzania
| | - Paul M Hayuma
- National Institute for Medical Research, Tanga, Tanzania
| | - Rashid A Madebe
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | | | | | | | - Ritha Njau
- World Health Organization Country Office, Dar es Salaam, Tanzania
| | - Ally Mohamed
- National Malaria Control Programme, Dodoma, Tanzania
| | - Susan F Rumisha
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Malaria Atlas Project, Geospatial Health and Development, Telethon Kids Institute, Perth, WA, Australia
| | - Deus S Ishengoma
- National Institute for Medical Research, Dar es Salaam, Tanzania
- Faculty of Pharmaceutical Sciences, Monash University, Melbourne, Australia
- Harvard T.H Chan School of Public Health, Harvard University, Boston, MA, USA
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Owiny MO, Ngare BK, Mugo BC, Rotich J, Mutembei A, Chepkorir K, Sitawa R, Obonyo M, Onono JO. Assessment of community perceptions and risk to common zoonotic diseases among communities living at the human-livestock-wildlife interface in Nakuru West, Kenya: A participatory epidemiology approach. PLoS Negl Trop Dis 2023; 17:e0011086. [PMID: 36701376 PMCID: PMC9904458 DOI: 10.1371/journal.pntd.0011086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/07/2023] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Zoonoses account for most of the emerging and re-emerging infections in Kenya and in other low to medium-income countries across the world. The human-livestock-wildlife interface provides a nexus where transmission and spread of these zoonotic diseases could occur among communities farming in these areas. We sought to identify perceptions of the community living near the Lake Nakuru National Park in Kenya. METHODS We used participatory epidemiology techniques (PE) involving Focus Group Discussion (FGD) among community members and Key Informant Interviews (KII) with the health, veterinary, and administration officers in July 2020. We used listing, pairwise matching, and proportional piling techniques during the FGDs in the randomly selected villages in the study area from a list of villages provided by the area government officers. Kruskal-Wallis test was used to compare the median scores between the zoonotic diseases, source of information, and response to disease occurrence. Medians with a z-score greater than 1.96 at 95% Confidence Level were considered to be significant. Content analysis was used to rank qualitative variables. RESULTS We conducted seven FGDs and four KIIs. A total of 89 participants took part in the FGDs with their ages ranging from 26 to 85 years. Common zoonotic diseases identified by participants included anthrax, rabies, and brucellosis. Anthrax was considered to have the greatest impact by the participants (median = 4, z>1.96), while 4/7 (57%) of the FGDs identified consumption of uninspected meat as a way that people can get infected with zoonotic diseases. Community Health Volunteers (Median = 28, z = 2.13) and the government veterinary officer (median = 7, z = 1.8) were the preferred sources of information during disease outbreaks. CONCLUSION The participants knew the zoonotic diseases common in the area and how the diseases can be acquired. We recommend increased involvement of the community in epidemio-surveillance of zoonotic diseases at the human-wildlife-livestock interface.
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Affiliation(s)
- Maurice Omondi Owiny
- Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya
- * E-mail:
| | - Ben Kipchumba Ngare
- Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya
| | - Bernard Chege Mugo
- Kenya Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya
| | - Jacob Rotich
- Department of Health, County Government of Nakuru, Nakuru, Kenya
| | - Arithi Mutembei
- Department of Agriculture, Wajir County Government, Wajir, Kenya
| | | | - Rinah Sitawa
- Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Mark Obonyo
- Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
- Food and Agriculture Organization of the United Nations, Nairobi, Kenya
| | - Joshua Orungo Onono
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi, Kenya
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Sserwanja Q, Sepenu AS, Mwamba D, Mukunya D. Access to mass media and teenage pregnancy among adolescents in Zambia: a national cross-sectional survey. BMJ Open 2022; 12:e052684. [PMID: 35701065 PMCID: PMC9198694 DOI: 10.1136/bmjopen-2021-052684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Teenage pregnancies and childbirths are associated with negative health outcomes. Access to health information enables adolescents to make appropriate decisions. However, the relationship between access to health information through mass media and teenage pregnancy has not received much attention in existing literature. We therefore examined the association between access to mass media and teenage pregnancy in Zambia. DESIGN Cross-sectional. SETTING Zambia. PARTICIPANTS Weighted sample of 3000 adolescents aged 15-19 years. OUTCOME MEASURE Teenage pregnancy that included adolescents who were currently pregnant or had had an abortion or had given birth in the last 5 years preceding the survey. RESULTS Out of 3000 adolescents, 897 (29.9%, 95% CI: 28.1% to 31.3%) were pregnant or had ever been pregnant. Majority of the adolescents resided in rural areas (55.9%) and had secondary education (53.6%). Adolescents who had exposure to internet, newspapers or magazines, radio and television were 10.5%, 22.6%, 43.1% and 43.1%, respectively. Adolescents who had daily access to newspapers or magazines (adjusted OR (AOR): 0.33, 95% CI: 0.13 to 0.82) or using internet (AOR: 0.54, 95% CI: 0.30 to 0.95) were less likely to be pregnant or to have had a pregnancy compared with those with no access to newspapers and internet, respectively. CONCLUSION Our study suggests that internet use and reading of newspapers or magazines may trigger behavioural change as an effective approach to reducing teenage pregnancy. Behavioural change communicators can implement mass media campaigns using newspapers, magazines and the internet to publicise adolescent health messages that can encourage adolescents to adopt healthy behaviours and prevent teenage pregnancies.
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Affiliation(s)
| | | | - Daniel Mwamba
- Programs Department, Center for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - David Mukunya
- Department of Public Health, Busitema University, Tororo, Uganda
- Research Department, Sanyu Africa Research Institute, Mbale, Uganda
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Kodaolu MY, Fagbamigbe AF, Ajayi IO. Stocking pattern for anti-malarial medications among proprietary patent medicine vendors in Akinyele Local Government Area, Ibadan, Nigeria. Malar J 2020; 19:279. [PMID: 32746914 PMCID: PMC7398199 DOI: 10.1186/s12936-020-03350-1] [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: 05/22/2020] [Accepted: 07/27/2020] [Indexed: 12/03/2022] Open
Abstract
Background Policymakers have recognized that proprietary patent medicine vendors (PPMVs) can provide an opportunity for effective scaling up of artemisinin-based combination therapy (ACT) since they constitute a major source of malaria treatment in Nigeria. This study was designed to determine the stocking pattern for anti-malarial medications, knowledge of the recommended anti-malarial medicine among PPMVs in Akinyele Local Government Area (LGA) of Oyo State, Nigeria and their perception on ways to improve PPMV adherence to stocking ACT medicines. Methods A cross-sectional survey was conducted among 320 PPMVs using a mixed method of data collection. Survey respondents were consecutively selected as a complete listing of all the PPMVs was not available. A pretested interviewer-administered questionnaire was used to collect quantitative data and two focus group discussions (FGD) were conducted among PPMVs using a pretested FGD guide. Results Most PPMVs stocked artemether-lumefantrine (90.9%), dihydroartemisinin-piperaquine (5.3%) and artesunate-amodiaquine (2.8%). Drugs contrary to the policy, which included sulfadoxine-pyrimethamine, chloroquine, quinine, halofantrine, artesunate, and artemether were stocked by 93.8, 22.8, 0.6, 1.3, 6.6, and 7.8% of the PPMVs, respectively. Most PPMVs (96.3%) had good knowledge of artemether-lumefantrine as the first-line treatment for malaria and 2.8% had good knowledge of artesunate-amodiaquine as the alternate treatment for malaria. The major factors influencing stocking decision were government recommendations (41.3%) and consumer demand (40.30%). Conclusion Stocking of artemisinin-based combinations was high among PPMVs, although they also stocked and dispensed other anti-malarial drugs and this has serious implications for drug resistance development. The PPMVs had considerable knowledge of the recommended treatment for uncomplicated malaria and stocking decisions were overwhelmingly driven by consumer demand. However, there is a need for more enlightenment on discontinuation of government-banned anti-malarial drugs.
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Zalisk K, Herrera S, Inyang U, Mohammed AB, Uhomoibhi P, Yé Y. Caregiver exposure to malaria social and behaviour change messages can improve bed net use among children in an endemic country: secondary analysis of the 2015 Nigeria Malaria Indicator Survey. Malar J 2019; 18:121. [PMID: 30954073 PMCID: PMC6451249 DOI: 10.1186/s12936-019-2750-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background To reduce the malaria burden in Nigeria, the National Malaria Strategic Plan (NMSP) 2014‒2020 calls for the scale-up of prevention and treatment interventions, including social and behaviour change (SBC). SBC interventions can increase awareness and improve the demand for and uptake of malaria interventions. However, there is limited evidence supporting the implementation of SBC interventions to improve key malaria behaviours, such as insecticide-treated bed net (ITN) use, among children in Nigeria. Methods Using data from 2015 Nigeria Malaria Indicator Survey, this study used multiple logistic regression to assess the relationship between caregiver exposure to malaria messages and ITN use among children under five. Results Caregiver exposure to ITN-related messages was significantly associated with ITN use among children under five (odds ratio [OR] = 1.63, p < 0.001). Conclusions The results suggest that caregiver exposure to topic-specific SBC messages improves the use of ITNs among children. Given these results, Nigeria should strive to scale up SBC interventions to help increase ITN use among children in line with the objectives of the NMSP. Further evidence is needed to determine which SBC interventions are the most effective and scalable in Nigeria.
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Affiliation(s)
- Kirsten Zalisk
- MEASURE Evaluation, ICF, 530 Gaither Road, Suite 500, Rockville, MD, 20850, USA.
| | - Samantha Herrera
- MEASURE Evaluation, ICF, 530 Gaither Road, Suite 500, Rockville, MD, 20850, USA.,Save the Children, 899 North Capitol Street NE #900, Washington, DC, 20002, USA
| | - Uwem Inyang
- President's Malaria Initiative/United States Agency for International Development, Plot 1075 Diplomatic Drive, Central District Area, Abuja, Nigeria
| | - Audu Bala Mohammed
- National Malaria Elimination Programme, Federal Ministry of Health Nigeria, 1st Floor, Abia Plaza, 1 Avenue, Cadastral Zone A0, Central Business District, Abuja, Nigeria
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health Nigeria, 1st Floor, Abia Plaza, 1 Avenue, Cadastral Zone A0, Central Business District, Abuja, Nigeria
| | - Yazoumé Yé
- MEASURE Evaluation, ICF, 530 Gaither Road, Suite 500, Rockville, MD, 20850, USA
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Sultana M, Sheikh N, Mahumud RA, Jahir T, Islam Z, Sarker AR. Prevalence and associated determinants of malaria parasites among Kenyan children. Trop Med Health 2017; 45:25. [PMID: 29085254 PMCID: PMC5651573 DOI: 10.1186/s41182-017-0066-5] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 08/17/2017] [Indexed: 11/15/2022] Open
Abstract
Background Approximately 80% of deaths attributed to malaria worldwide occurred mainly in Africa in 2015. Kenya is one of the major malaria endemic countries, making malaria the leading public health concern in this country. This study intended to document the prevalence of malaria and determine associated factors including socioeconomic status among children aged 6 months to 14 years in Kenya. Methods This study analyzed the secondary data extracted from the 2015 Kenya Malaria Indicator Survey (KMIS), a cross-sectional country representative survey. Associations of demographic, socioeconomic, community-based, and behavioral factors with the prevalence of malaria in children were analyzed using multivariable logistic regression analysis. Results Data from 7040 children aged 6 months to 14 years were analyzed. The prevalence of malaria showed an upward trend in terms of age, with the highest prevalence among children aged 11–14 years. Prevalence was also higher among rural children (10.16%) compared to urban children (2.93%), as well as poor children (11.05%) compared to rich children (3.23%). The likelihood of having malaria was higher among children aged 10–14 years (AOR = 4.47, 95% CI = 3.33, 6.02; P < 0.001) compared with children aged under 5 years. The presence of anemia (AOR = 3.52, 95% CI = 2.78, 4.45; P < 0.001), rural residence (AOR = 1.71, 95% CI = 1.31, 2.22; P < 0.001), lack of a hanging mosquito net (AOR = 2.38, 95% CI = 1.78, 3.19; P < 0.001), primary education level of the household head (AOR = 1.15, 95% CI = 1.08, 2.25; P < 0.05), and other factors, such as the household having electricity and access to media such as television or radio, were also associated with the likelihood of infection. Conclusion This study demonstrated the need to focus on awareness programs to prevent malaria and to use existing knowledge in practice to control the malaria burden in Kenya. Furthermore, this study suggests that improving the information available through the mass media and introducing behavior change communication and intervention program specifically for those of poor socioeconomic status will help to reduce malaria cases.
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Affiliation(s)
- Marufa Sultana
- Health Economics & Financing Research Group, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Nurnabi Sheikh
- Health Economics & Financing Research Group, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Rashidul Alam Mahumud
- Health Economics & Financing Research Group, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Tania Jahir
- Health Economics & Financing Research Group, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Ziaul Islam
- Health Economics & Financing Research Group, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh
| | - Abdur Razzaque Sarker
- Health Economics & Financing Research Group, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), 68 Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka, 1212 Bangladesh.,University of Strathclyde, Glasgow, UK
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Zamawe COF, Banda M, Dube AN. The impact of a community driven mass media campaign on the utilisation of maternal health care services in rural Malawi. BMC Pregnancy Childbirth 2016; 16:21. [PMID: 26819242 PMCID: PMC4730729 DOI: 10.1186/s12884-016-0816-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 01/25/2016] [Indexed: 11/16/2022] Open
Abstract
Background Mass media is critical in disseminating public health information, improving health knowledge and changing health behaviours. However, most of the mass media public health interventions do not sufficiently engage the local people; they are externally determined. Due to this, very little is known about the effects of locally instigated mass media promotion. Therefore, the aim of this study was to examine the impact of a community driven mass media campaign called Phukusi la Moyo (tips of life) on the utilisation of maternal health care services. Methods A community-based cross-sectional study involving 3825 women of reproductive age (15–49 years) was conducted in rural Malawi to evaluate the Phukusi la Moyo (PLM) campaign. To do this, we compared the utilisation of maternal health care services between women who were exposed to the PLM campaign and those who were not. Respondents were identified using a multistage cluster sampling method. This involved systematically selecting communities (clusters), households and respondents. Associations were examined using Pearson chi square test and a multivariable logistic regression model. Results The likelihood of using contraceptives (AOR = 1.61; 95 % CI = 1.32–1.96), sleeping under mosquito bed-nets (AOR = 1.65; 95 % CI = 1.39–1.97), utilising antenatal care services (AOR = 2.62; 95 % CI = 1.45–4.73) and utilising postnatal care services (AOR = 1.59; CI = 1.29–1.95) were significantly higher among women who had exposure to the PLM campaign than those who did not. No significant association was found between health facility delivery and exposure to the PLM campaign. Conclusion Women exposed to a community driven mass media campaign in rural Malawi were more likely to utilise maternal health care services than their unexposed counterparts. Since, the use of maternal health care services reduces the risk of maternal morbidity and mortality, community-led mass media could play a significant role towards improving maternal health outcomes in low-and-middle-income countries. Therefore, we recommend the use of locally driven mass media in disseminating public health information in limited resource settings.
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Affiliation(s)
- Collins O F Zamawe
- Parent and Child Health Initiative (PACHI), Research Centre, Amina house, Off Chilambula Road, P.O. Box 31686, Capital City, Lilongwe, 3, Malawi. .,The Ministry of Health, Lilongwe, Malawi.
| | | | - Albert N Dube
- Parent and Child Health Initiative (PACHI), Research Centre, Amina house, Off Chilambula Road, P.O. Box 31686, Capital City, Lilongwe, 3, Malawi.,The University of Malawi, College of Medicine, School of Public Health, Blantyre, Malawi
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