RESUMO
BACKGROUND: Mining in the Amazon exposes gold miners to various diseases, including malaria, whose control is still a major challenge. The environment of the mines contributes to the proliferation of vector mosquitoes and the precarious housing conditions facilitate transmission of the disease. Understanding gold miners' perceptions is essential for the formulation of strategies to fight malaria. A qualitative study was carried out in the municipality of Calçoene, state of Amapá, Brazilian Amazon adjointining the municipality of Oiapoque, that is in the border area with French Guiana and Suriname. METHODS: A semi-structured interview was applied to an intentional sample of 29 miners, a number determined by the theoretical saturation criterion. Thematic analysis was adopted to obtain the results and the Cohen's Kappa index was calculated to verify the agreement between observers during coding. RESULTS: The agreement between observers was verified by a Cohen's Kappa index of 0.82. Analysis of the interviews showed that gold miners were subjected to prejudice from the community due to forest diseases that they can transmit, and their activities are often associated with crime. When the miners return to their hometown after a period of mining, the urban population blames them for the onset of diseases such as malaria. Most participants in the survey did not know how malaria transmission occurs, and associated its occurrence with contaminated water and food. Participants reported not being afraid of the disease, trusting the diagnosis and available treatment, though this depends on where they are treated. The use of therapeutic resources, such as medicinal plants and medicines acquired in the illegal market, is very common in this population. Despite the challenges identified by the research subjects, they believe that the disease can be controlled, or the cases reduced, but there was low acceptability for a possible mass drug administration (MDA) intervention. CONCLUSION: Despite a recent reduction in malaria prevalence in Brazil, there are still vulnerable populations, such as gold miners, who help to perpetuate the existence of the disease in the Amazon. The lack of knowledge regarding how the transmission of malaria occurs, associated with myths regarding this and the use of traditional health practices and illegal drugs for the treatment of the disease without a specific diagnosis, jeopardizes the country's efforts to eliminate malaria. It is necessary to implement control programmes in these populations, especially those who frequently travel around the border region and to remote locations, which are difficult regions for health teams to access, thus hindering diagnostic and treatment actions. For this reason, understanding the perceptions of these individuals as well as their customs, beliefs and lifestyle, can assist in the production of targeted educational material and adoption of strategies in the elimination of malaria in the country.
Assuntos
Erradicação de Doenças/estatística & dados numéricos , Malária/psicologia , Mineradores/psicologia , Brasil , Conhecimentos, Atitudes e Prática em Saúde , Mineradores/estatística & dados numéricosRESUMO
BACKGROUND: In the Dominican Republic, a recent outbreak of malaria in the capital, Santo Domingo, threatens efforts to eliminate the disease. Mass drug administration (MDA) has been proposed as one strategy to reduce transmission. The success of MDA is contingent upon high levels of acceptance among the target population. To inform the design of future MDA campaigns, this rapid ethnographic assessment examined malaria-related knowledge and attitudes toward malaria MDA among residents of a transmission focus in Santo Domingo. METHODS: In October 2019, a rapid ethnographic assessment was conducted in the Los Tres Brazos transmission focus, which had not previously received MDA. National malaria programme staff conducted 61 structured interviews with key informants, recorded observations, and held 72 informal conversations. Using a grounded theory approach, data were analysed during three workshop sessions with research team members. RESULTS: Among those who had heard of malaria in the structured interviews (n = 39/61; 64%), understanding of the disease was largely based on personal experience from past outbreaks or through word-of-mouth. Community health workers (promotores) were trusted for health information and malaria diagnosis more so than professional clinicians. No participant (0%) was familiar with malaria MDA. After learning about MDA, almost all study participants (92%) said that they would participate, seeing it as a way to care for their community. Reasons for not participating in future MDA included not trusting drug administrators, feeling reluctant to take unprescribed medicine, and fear of missing work. Additional identified challenges to MDA included reaching specific demographic groups, disseminating effective MDA campaign messages, and managing misinformation and political influence. CONCLUSION: Residents appear accepting of MDA despite a lack of prior familiarity. Successful MDA will depend on several factors: fostering relationships among community-based health workers, clinicians, community leaders, and others; developing clear health messages that use local terms and spreading them through a variety of media and social networks; and contextualizing MDA as part of a broader effort to promote community health.
Assuntos
Antimaláricos/administração & dosagem , Conhecimentos, Atitudes e Prática em Saúde , Malária/psicologia , Administração Massiva de Medicamentos/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropologia Cultural , República Dominicana/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: Malaria primarily affects populations living in poor socioeconomic conditions, with limited access to basic services, deteriorating environmental conditions, and barriers to accessing health services. Control programmes are designed without participation from the communities involved, ignoring local knowledge and sociopolitical and cultural dynamics surrounding their main health problems, which implies imposing decontextualized control measures that reduce coverage and the impact of interventions. The objective of this study was to determine the community perception of malaria in the municipality of Olaya Herrera in the Colombian Pacific. METHODS: A 41-question survey on knowledge, attitudes, and practices (KAP) related to malaria, the perception of actions by the Department of Health, and access to the health services network was conducted. RESULTS: A total of 134 adults were surveyed, in whose households a total of 671 people lived. According to the survey data, about 80% of the household members included teenagers and children, out of which 61% had malaria at one time, and for 75.3%, this disease is a persistent problem. In spite of this, 57.2% of people who fell ill due to malaria were never visited by health personnel for a follow up. This population claimed that responsibility for who should prevent the disease is shared between each person and the Department of Health. However, personal actions were focused on using mosquito nets, ignoring other important practices to prevent bites. Despite campaigns by the Department of Health, 11.9% of respondents did not know how malaria was transmitted, and 8.96% thought it was transmitted through water. Also, 43.5% said that the Department of Health did not do any work to control malaria and 16% did not know if any action was taken. CONCLUSIONS: In spite of the knowledge about malaria and the efforts of the Department of Health to prevent it, the community actions do not seem to be consistent with this knowledge, as the number of cases of malaria is still high in the area.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/psicologia , Percepção , Adulto , Idoso , Idoso de 80 Anos ou mais , Colômbia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: The island of Hispaniola, shared by Haiti and the Dominican Republic (DR), is the only remaining malaria-endemic island in the Caribbean and accounts for 95% of the lymphatic filariasis (LF) burden in the Americas. Both countries aim to eliminate the diseases by 2020. Migration from Haiti, where both diseases are more prevalent, may promote transmission in the DR. Historically, Haitian migrant labourers live in rural Dominican agricultural 'company towns' called bateyes, many of which received mass drug administration (MDA) for LF elimination. This study sought to determine the prevalence of malaria and LF in bateyes of the DR and to describe related risk factors for disease. METHODS: From March to April 2016, a cross-sectional, cluster survey was conducted across Dominican bateyes stratified into three regions: southwest, north and east. A household questionnaire (n = 776), captured demographics, ethnic origin, mobility patterns, malaria intervention coverage, and knowledge, and recent fever and treatment-seeking. Two individuals per household (n = 1418) were tested for malaria parasites by microscopy and rapid diagnostic test (RDT) and LF antigen by filariasis test strip (FTS). Population-level estimates and confidence intervals (CI) were computed adjusting for the survey design. Two-sided t-tests compared differences in knowledge scores. RESULTS: No (0%) blood sample was Plasmodium-positive by microscopy or RDT. Six individuals were FTS-positive (0.5%; 95% CI: 0.2-1.5), but none (0%) of these were microfilariae-positive. Most batey residents were born in the DR (57.8%), documented (85.0%), and permanent residents (85.1%). Very few respondents (9.4%) reported travel to Haiti in the past year. Overall, half (53.8%) of respondents owned a bed net, and 82.3% of net owners reported using it the previous night. Indoor residual spraying (IRS) differed by region (range: 4.7%-61.2%). Most of those with recent fever sought care (56.0%), yet only 30.5% of those seeking care were tested for malaria. Compared to Dominican-born populations, Haitian-born respondents more frequently reported recent fever, did not seek care for the fever, had not heard of malaria, and could not name symptoms or prevention methods. CONCLUSIONS: Malaria and LF transmission appear absent or extremely low in Dominican bateyes, which are a mixture of Haitian and Dominican residents. Travel to Haiti is rare, meaning risk of malaria and LF importation is low. Addressing identified gaps in intervention coverage, malaria knowledge, treatment seeking and service delivery will improve the quality of surveillance for these diseases, particularly among marginalized populations and promote island-wide elimination.
Assuntos
Filariose Linfática/epidemiologia , Filariose Linfática/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Malária/epidemiologia , Malária/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Helmintos , Antígenos de Protozoários , Criança , Pré-Escolar , Estudos Transversais , República Dominicana/epidemiologia , Filariose Linfática/sangue , Feminino , Haiti/etnologia , Humanos , Malária/sangue , Malária/prevenção & controle , Masculino , Administração Massiva de Medicamentos , Pessoa de Meia-Idade , Mosquiteiros , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Fatores de Risco , Inquéritos e Questionários , Migrantes , Adulto JovemRESUMO
OBJECTIVE: To describe the condition of malaria in the District 5 of San Andres de Tumaco-Nariño-Colombia, with regards to knowledge, attitudes, perceptions, and community practices. METHODS: A cross-sectional study was conducted between January and May 2014. Logistic analysis of the CAP-PP survey of the Pan American Health Organization (PAHO) was carried out. Statistical modeling was adjusted through the logarithm of likelihood test, the Pseudo R2, the Akaike's Information Criterion (AIC) and the Bayesian Information Criterion (BIC). Results. The variables that influence the disease of malaria are: taking medicines, malaria tests and vector control by spraying at home. It is important to keep clean ditches around the house in order for people to be protected against the disease. CONCLUSION: Although the population reported having knowledge, attitudes, community practices, and perceptions about the issue, these do not generate protection against the disease. Variables such as carrying out activities in the family and ignorance about the name of the mosquito that transmits malaria must be taken into account for the formulation of community intervention plans.
OBJETIVO: Describir el padecimiento de la malaria en la Comuna 5 de San Andrés de Tumaco-Nariño, Colombia, en cuanto a conocimientos, actitudes, percepciones, y prácticas comunitarias. MATERIALES Y MÉTODOS: Estudio de corte transversal, realizado entre enero y mayo de 2014. Se realizó análisis logístico de la encuesta CAP-PP de la Organización Panamericana de la Salud (OPS). El modelamiento estadístico se ajustó a través del test del logaritmo de la verosimilitud, el Pseudo R2, el Akaike's Information Criterion (AIC) y el Bayesian Information Criterion (BIC). Resultados Las variables que influyen en el padecimiento de la malaria son: tomar medicamentos, examen para malaria y control de vectores mediante rociamiento en casa. Es importante mantener las zanjas limpias alrededor de la vivienda para protegerse contra la enfermedad. CONCLUSIÓN: A pesar de que la población manifiesta tener conocimientos, actitudes, prácticas comunitarias y percepciones, estas no generan protección contra la enfermedad. Variables como la realización de actividades en la familia y el desconocimiento del nombre del mosquito que trasmite la malaria deben ser tenidas en cuenta para la formulación de planes de intervención comunitaria.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/prevenção & controle , Saúde da População Urbana , Teorema de Bayes , Colômbia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Malária/psicologia , MasculinoRESUMO
BACKGROUND: In Peru, despite decades of concerted control efforts, malaria remains a significant public health burden. Peru has recently exhibited a dramatic rise in malaria incidence, impeding South America's progress towards malaria elimination. The Amazon basin, in particular the Loreto region of Peru, has been identified as a target for the implementation of intensified control strategies, aiming for elimination. No research has addressed why vector control strategies in Loreto have had limited impact in the past, despite vector control elsewhere being highly effective in reducing malaria transmission. This study employed qualitative methods to explore factors limiting the success of vector control strategies in the region. METHODS: Twenty semi-structured interviews were conducted among adults attending a primary care centre in Iquitos, Peru, together with 3 interviews with key informants (health care professionals). The interviews focussed on how local knowledge, together with social and cultural attitudes, determined the use of vector control methods. RESULTS: Five themes emerged. (a) Participants believed malaria to be embedded within their culture, and commonly blamed this for a lack of regard for prevention. (b) They perceived a shift in mosquito biting times to early evening, rendering night-time use of bed nets less effective. (c) Poor preventive practices were compounded by a consensus that malaria prevention was the government's responsibility, and that this reduced motivation for personal prevention. (d) Participants confused the purpose of space-spraying. (e) Participants' responses also exposed persisting misconceptions, mainly concerning the cause of malaria and best practices for its prevention. CONCLUSION: To eliminate malaria from the Americas, region-specific strategies need to be developed that take into account the local social and cultural contexts. In Loreto, further research is needed to explore the potential shift in biting behaviour of Anopheles darlingi, and how this interacts with the population's social behaviours and current use of preventive measures. Attitudes concerning personal responsibility for malaria prevention and long-standing misconceptions as to the cause of malaria and best preventive practices also need to be addressed.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Malária/psicologia , Percepção , Prevenção Primária/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Anopheles/fisiologia , Feminino , Humanos , Mordeduras e Picadas de Insetos/epidemiologia , Malária/prevenção & controle , Masculino , Pessoa de Meia-Idade , Mosquitos Vetores/fisiologia , Peru/epidemiologia , Pesquisa Qualitativa , Adulto JovemRESUMO
BACKGROUND: Malaria is one of the most prevalent parasitic diseases in the world and represents a threat to travellers visiting endemic areas. Chemoprophylaxis is the prevention measure used in travel medicine, avoiding clinical manifestations and protecting against the development of severe disease and death. METHODS: Retrospective and descriptive analysis of malaria prevention data in travellers was recorded from a travel medicine clinic in São Paulo, Brazil, between January 2006 and December 2010. All the medical records of travellers, who had travelled to areas with risk of disease transmission, including Brazil, were analysed. Demographic characteristics of travellers, travel details and recommendations for preventing malaria were also seen. RESULTS: During the study period, 2836 pre-travel consultations were carried out on 2744 individuals (92 were consulted twice). The most common reasons for travelling were tourism and work. The most common destinations were Africa (24.5%), Europe (21.2%), Asia (16.6%) and locations within Brazil (14.9%). In general prophylaxis against malaria was recommended in 10.3% of all the consultations. African destinations vs Asian, Brazilian and other destinations and length of stay ≤30 days were independently associated with the higher odds of chemoprophylaxis recommendation after the logistic regression. CONCLUSION: The prophylaxis against malaria was recommended in 10.3% of the consultations. The authors believe that a coherent measure of malaria prevention in Brazil and for international travellers would be to recommend for all parts of the North Brazil, avoidance of mosquito bites and immediate consultation of a physician in case of fever during or after the journey is recommended.
Assuntos
Quimioprevenção/estatística & dados numéricos , Aconselhamento , Malária/prevenção & controle , Medicina de Viagem/estatística & dados numéricos , Adolescente , Adulto , Idoso , Instituições de Assistência Ambulatorial , Brasil , Criança , Pré-Escolar , Aconselhamento/estatística & dados numéricos , Feminino , Humanos , Lactente , Malária/psicologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Viagem , Adulto JovemRESUMO
INTRODUCTION: Malaria remains an important public health problem despite recent scientific breakthroughs regarding knowledge about malaria and treatment strategies. The objective of this study was to analyze malaria patients' knowledge about the disease, its treatment and prevention, linking it to drug treatment adherence. METHODOLOGY: A descriptive, cross-sectional, epidemiological survey study was conducted in the district of Três Fronteiras-MT. The study included 618 individuals who were interviewed and examined for Plasmodium infection. Of the 52 patients diagnosed with malaria, 27 were visited at home for an interview about malaria knowledge and treatment adherence. Treatment adherence was evaluated by self-reports and drug conference. RESULTS: A total of 18 patients had satisfactory knowledge (66.6%) and 9 were evaluated as having unsatisfactory knowledge (33.4%) about malaria. Of the 27 malaria patients, 21 (77.8%) reported having taken all the medication as prescribed, in the correct period of time and dosage, and had no medication tablets remaining. The majority (72.2%) of patients who had satisfactory knowledge, as well as the majority (88.8%) of those who had unsatisfactory knowledge, adhered to the malaria treatment. CONCLUSIONS: This study revealed a high proportion of patients with satisfactory prior knowledge about malaria and revealed that this knowledge was not related to disease treatment adherence. These results have implications for planning strategies for malaria control in the region and could contribute to the reduction in the cases of non-adherence to malaria treatment.
Assuntos
Antimaláricos/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Malária/tratamento farmacológico , Malária/epidemiologia , Adesão à Medicação , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Estudos Epidemiológicos , Feminino , Humanos , Entrevistas como Assunto , Malária/psicologia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Introducción. Las encuestas sobre comportamientos, actitudes y prácticas permiten determinar el grado de conocimiento de la población sobre la malaria o paludismo, así como las actitudes y prácticas que contribuyen a su transmisión. Objetivo. Identificar los conocimientos, actitudes y prácticas que favorecen la transmisión de la malaria en la población indígena guna de Madungandí. Materiales y métodos. Se hizo un estudio transversal mediante una encuesta a los jefes de familia de una muestra de 40 % de las viviendas en tres comunidades con alta incidencia de malaria. La encuesta se hizo con encuestadores gunas e integrantes del equipo de investigación, y con la ayuda de un traductor. El análisis se hizo en Epi-Info 6.04. Resultados. El rango de edad de los encuestados fluctuaba entre los 20 y los 70 años. Todos los encuestados indicaron pertenecer a la etnia guna y hablar su lengua; 64 % eran del sexo masculino y 30 % eran analfabetas. La mitad de los encuestados (51 %) manifestó haber enfermado de malaria, por lo menos, una vez en los últimos ocho años y 89 % reconoció la enfermedad como un problema de salud. El 63 % manifestó que el médico tradicional "inadule" curaba la malaria, y 78 % practicaba la "fuma de la pipa" y la "quema del cacao" para prevenirla. Conclusión. Dado el limitado conocimiento sobre la malaria y su vector, así como la actitud de colaboración de la población guna, es necesario iniciar programas educativos y de participación comunitaria para mejorar las prácticas de prevención y control en las comunidades, y disminuir así la incidencia de la enfermedad en la comarca de Madungandí.
Introduction: Knowledge, attitudes and practices surveys allow to determine the degree of knowledge on the management of malaria in a given population, as well as the attitudes and practices that contribute or not to its transmission. Objective: To identify the knowledge, attitudes and practices that favor or not the transmission of malaria in the indigenous Guna population of Madungandí. Materials and methods: A cross-sectional study was conducted by applying a survey to the heads of the families in a sample of 40% of households in three communities with high malaria incidence. Local Guna residents and translators were part of the research team that applied the questionnaires. The statistical analysis was performed in Epi-Info 6.04. Results: The age range of those surveyed was between 20 and 70 years. All responders indicated that they belonged to and spoke the language of the Guna ethnic group, 64% were male and 30% were illiterate. Half (51%) of the responders declared they had suffered malaria at least once in the last eight years, and 89% accepted that malaria was a health problem. Sixty-three per cent responded that their traditional doctors, inadule, cured malaria and 7.0 % practiced the pipe smoking and cocoa burn rituals to prevent the disease. Conclusion: Considering the limited knowledge about malaria and its vector, as well as the willingness to collaborate shown by the Guna population, it is essential to initiate educational and participative programs to improve control and prevention activities in the communities aimed at achieving a reduction in malaria incidence in the Madungandí indigenous region.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Indígenas Centro-Americanos/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Malária/psicologia , Fatores Socioeconômicos , Controle de Mosquitos , Incidência , Estudos Transversais , Inquéritos e Questionários , Participação da Comunidade , Alfabetização , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Malária/prevenção & controle , Malária/transmissão , Medicina TradicionalRESUMO
INTRODUCTION: Knowledge, attitudes and practices surveys allow to determine the degree of knowledge on the management of malaria in a given population, as well as the attitudes and practices that contribute or not to its transmission. OBJECTIVE: To identify the knowledge, attitudes and practices that favor or not the transmission of malaria in the indigenous Guna population of Madungandí. MATERIALS AND METHODS: A cross-sectional study was conducted by applying a survey to the heads of the families in a sample of 40% of households in three communities with high malaria incidence. Local Guna residents and translators were part of the research team that applied the questionnaires. The statistical analysis was performed in Epi-Info 6.04. RESULTS: The age range of those surveyed was between 20 and 70 years. All responders indicated that they belonged to and spoke the language of the Guna ethnic group, 64% were male and 30% were illiterate. Half (51%) of the responders declared they had suffered malaria at least once in the last eight years, and 89% accepted that malaria was a health problem. Sixty-three per cent responded that their traditional doctors, inadule, cured malaria and 7.0 % practiced the pipe smoking and cocoa burn rituals to prevent the disease. CONCLUSION: Considering the limited knowledge about malaria and its vector, as well as the willingness to collaborate shown by the Guna population, it is essential to initiate educational and participative programs to improve control and prevention activities in the communities aimed at achieving a reduction in malaria incidence in the Madungandí indigenous region.