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Community perceptions on outdoor malaria transmission in Kilombero Valley, Southern Tanzania.
Malar J. 2017 07 04; 16(1):274.MJ

Abstract

BACKGROUND

The extensive use of indoor residual spraying (IRS) and insecticide-treated nets (ITNs) in Africa has contributed to a significant reduction in malaria transmission. Even so, residual malaria transmission persists in many regions, partly driven by mosquitoes that bite people outdoors. In areas where Anopheles gambiae s.s. is a dominant vector, most interventions target the reduction of indoor transmission. The increased use of ITNs/LLINs and IRS has led to the decline of this species. As a result, less dominant vectors such as Anopheles funestus and Anopheles arabiensis, both also originally indoor vectors but are increasingly biting outdoors, contribute more to residual malaria transmission. The study reports the investigated community perceptions on malaria and their implications of this for ongoing outdoor malaria transmission and malaria control efforts.

METHODS

This was a qualitative study conducted in two rural villages and two peri-urban areas located in Kilombero Valley in south-eastern Tanzania. 40 semi-structured in-depth interviews and 8 focus group discussions were conducted with men and women who had children under the age of five. The Interviews and discussions focused on (1) community knowledge of malaria transmission, and (2) the role of such knowledge on outdoor malaria transmission as a contributing factor to residual malaria transmission.

RESULTS

The use of bed nets for malaria prevention has been stressed in a number of campaigns and malaria prevention programmes. Most people interviewed believe that there is outdoor malaria transmission since they use interventions while indoors, but they are unaware of changing mosquito host-seeking behaviour. Participants pointed out that they were frequently bitten by mosquitoes during the evening when outdoors, compared to when they were indoors. Most participants stay outdoors in the early evening to undertake domestic tasks that cannot be conducted indoors. House structure, poor ventilation and warm weather conditions were reported to be the main reasons for staying outdoors during the evening. Participants reported wearing long sleeved clothes, fanning and slapping themselves, using repellents, and burning cow dung and neem tree leaves to chase away mosquitoes.

CONCLUSIONS

Community understanding of multiple prevention strategies is crucial given changes in mosquito host seeking behaviour and the increased incidence of outdoor biting. The current low use of outdoor control measures is attributed largely to limited awareness of outdoor transmission. Improved community understanding of outdoor malaria transmission is critical: efforts to reduce or eliminate malaria transmission will not be successful if the control of outdoor transmission is not emphasized.

Authors+Show Affiliations

Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-Es-Salaam, United Republic of Tanzania. imoshi@ihi.or.tz. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, Republic of South Africa. imoshi@ihi.or.tz.Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-Es-Salaam, United Republic of Tanzania.Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-Es-Salaam, United Republic of Tanzania.Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-Es-Salaam, United Republic of Tanzania.Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-Es-Salaam, United Republic of Tanzania.Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-Es-Salaam, United Republic of Tanzania. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, Republic of South Africa.Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Sandringham, Johannesburg, Republic of South Africa.Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Dar-Es-Salaam, United Republic of Tanzania. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, Republic of South Africa.School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, Republic of South Africa.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28676051

Citation

Moshi, Irene R., et al. "Community Perceptions On Outdoor Malaria Transmission in Kilombero Valley, Southern Tanzania." Malaria Journal, vol. 16, no. 1, 2017, p. 274.
Moshi IR, Ngowo H, Dillip A, et al. Community perceptions on outdoor malaria transmission in Kilombero Valley, Southern Tanzania. Malar J. 2017;16(1):274.
Moshi, I. R., Ngowo, H., Dillip, A., Msellemu, D., Madumla, E. P., Okumu, F. O., Coetzee, M., Mnyone, L. L., & Manderson, L. (2017). Community perceptions on outdoor malaria transmission in Kilombero Valley, Southern Tanzania. Malaria Journal, 16(1), 274. https://doi.org/10.1186/s12936-017-1924-7
Moshi IR, et al. Community Perceptions On Outdoor Malaria Transmission in Kilombero Valley, Southern Tanzania. Malar J. 2017 07 4;16(1):274. PubMed PMID: 28676051.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Community perceptions on outdoor malaria transmission in Kilombero Valley, Southern Tanzania. AU - Moshi,Irene R, AU - Ngowo,Halfan, AU - Dillip,Angel, AU - Msellemu,Daniel, AU - Madumla,Edith P, AU - Okumu,Fredros O, AU - Coetzee,Maureen, AU - Mnyone,Ladslaus L, AU - Manderson,Lenore, Y1 - 2017/07/04/ PY - 2017/02/24/received PY - 2017/06/29/accepted PY - 2017/7/6/entrez PY - 2017/7/6/pubmed PY - 2018/3/27/medline KW - Community knowledge KW - Malaria prevention KW - Outdoor malaria transmission KW - Rural Tanzania SP - 274 EP - 274 JF - Malaria journal JO - Malar J VL - 16 IS - 1 N2 - BACKGROUND: The extensive use of indoor residual spraying (IRS) and insecticide-treated nets (ITNs) in Africa has contributed to a significant reduction in malaria transmission. Even so, residual malaria transmission persists in many regions, partly driven by mosquitoes that bite people outdoors. In areas where Anopheles gambiae s.s. is a dominant vector, most interventions target the reduction of indoor transmission. The increased use of ITNs/LLINs and IRS has led to the decline of this species. As a result, less dominant vectors such as Anopheles funestus and Anopheles arabiensis, both also originally indoor vectors but are increasingly biting outdoors, contribute more to residual malaria transmission. The study reports the investigated community perceptions on malaria and their implications of this for ongoing outdoor malaria transmission and malaria control efforts. METHODS: This was a qualitative study conducted in two rural villages and two peri-urban areas located in Kilombero Valley in south-eastern Tanzania. 40 semi-structured in-depth interviews and 8 focus group discussions were conducted with men and women who had children under the age of five. The Interviews and discussions focused on (1) community knowledge of malaria transmission, and (2) the role of such knowledge on outdoor malaria transmission as a contributing factor to residual malaria transmission. RESULTS: The use of bed nets for malaria prevention has been stressed in a number of campaigns and malaria prevention programmes. Most people interviewed believe that there is outdoor malaria transmission since they use interventions while indoors, but they are unaware of changing mosquito host-seeking behaviour. Participants pointed out that they were frequently bitten by mosquitoes during the evening when outdoors, compared to when they were indoors. Most participants stay outdoors in the early evening to undertake domestic tasks that cannot be conducted indoors. House structure, poor ventilation and warm weather conditions were reported to be the main reasons for staying outdoors during the evening. Participants reported wearing long sleeved clothes, fanning and slapping themselves, using repellents, and burning cow dung and neem tree leaves to chase away mosquitoes. CONCLUSIONS: Community understanding of multiple prevention strategies is crucial given changes in mosquito host seeking behaviour and the increased incidence of outdoor biting. The current low use of outdoor control measures is attributed largely to limited awareness of outdoor transmission. Improved community understanding of outdoor malaria transmission is critical: efforts to reduce or eliminate malaria transmission will not be successful if the control of outdoor transmission is not emphasized. SN - 1475-2875 UR - https://www.unboundmedicine.com/medline/citation/28676051/Community_perceptions_on_outdoor_malaria_transmission_in_Kilombero_Valley_Southern_Tanzania_ L2 - https://malariajournal.biomedcentral.com/articles/10.1186/s12936-017-1924-7 DB - PRIME DP - Unbound Medicine ER -