Challenges and opportunities for use of long-lasting insecticidal nets to prevent malaria during overnight travel in Uganda: a qualitative study

Abstract

Background. Travel is a well-recognized risk factor for malaria. Within sub-Saharan Africa, travellers from areas of lower to higher transmission intensity are potentially at high risk of malaria. Long-lasting insecticidal nets (LLINs) are the primary tool for prevention of malaria, and their widespread use has contributed to substantial reductions in malaria burden. However, travellers often fail to use LLINs. To further explore the challenges and opportunities of using LLINs, we interviewed travellers in Uganda. Methods. In August and September 2019, 20 participants attending outpatient clinics at Naguru General Hospital in Kampala with a history of travel out of Kampala within the previous 60 days were purposively selected. Data were collected through in-depth interviews and analysed thematically using NVivo 12. Results Of the 20 participants, 13 were male. Thirteen of the participants (65%) tested positive for malaria by microscopy. A total of 25% of the participants reported use of LLINs during travel. The main reasons for travel were to attend social events (weddings, funerals, overnight prayers) and for work. Travelers who attended social events reported using LLINs less commonly than those who travelled for work. Challenges to using LLINs during travel included: 1) limited access to LLINs, 2) inability to plan ahead for travel, 3) lack of space or ability to hang LLINs while traveling, 4) impression that LLINs in lodging places were unhygienic, 5) cultural beliefs discouraging use of LLINs during social events, 6) participation in overnight ceremonies and 7) doubts about efficacy of LLINs. Positive factors influencing use of LLINs during travel included knowledge regarding malaria prevention and good affordability and availability of LLINs. Conclusion Despite good traveller knowledge regarding malaria control measures, use of LLINs was limited. Use of LLINs in the prevention of malaria among travellers from low to high transmission settings needs to be prioritized. This calls for increased availability of LLINs and promotion of appropriate malaria prevention messages by the government to facilitate their adoption by overnight travellers.

“It is bad because it limits capacity building here back at home”Genetic and genomic researchers’ perspectives on biological sample sharing in collaborative research

“…Data analysis was conducted iteratively throughout the study using a thematic approach (Braun & Clarke, 2006; Fereday & Muir-Cochrane, 2006). A team based approach of thematic analysis was employed (Ekusai-Sebatta et al, 2021). Three of the authors (DES, DKM, and ESM) developed a codebook using both themes set a priori based on the literature review and survey outcomes from the quantitative study.…”