Community Knowledge and Acceptance of Larviciding for Malaria Control in a Rural District of East-Central Tanzania

Abstract

The use of microbial larvicides, a form of larval source management, is a less commonly used malaria control intervention that nonetheless has significant potential as a component of an integrated vector management strategy. We evaluated community acceptability of larviciding in a rural district in east-central Tanzania using data from 962 household surveys, 12 focus group discussions, and 24 in-depth interviews. Most survey respondents trusted in the safety (73.1%) and efficacy of larviciding, both with regards to mosquito control (92.3%) and to reduce malaria infection risk (91.9%). Probing these perceptions using a Likert scale provides a more detailed picture. Focus group participants and key informants were also receptive to larviciding, but stressed the importance of sensitization before its implementation. Overall, 73.4% of survey respondents expressed a willingness to make a nominal household contribution to a larviciding program, a proportion which decreased as the proposed contribution increased. The lower-bound mean willingness to pay is estimated at 2,934 Tanzanian Shillings (approximately US$1.76) per three month period. We present a multivariate probit regression analysis examining factors associated with willingness to pay. Overall, our findings point to a receptive environment in a rural setting in Tanzania for the use of microbial larvicides in malaria control.

Household knowledge, perceptions and practices of mosquito larval source management for malaria prevention and control in Mwanza district, Malawi: A cross-sectional study

“…Our study showed a high-level knowledge of mosquito LSM methods in the study area. Our nding is in contrast with an east-central Tanzanian study that reported a low community knowledge of mosquito LSM methods for malaria control (17). This was due to failure by policy makers and implementers to prioritise mosquito LSM methods in rural areas.…”

“…Our study also showed a very low proportion of respondents with knowledge of larviciding as a malaria control method. This nding is similar to a study in east-central Tanzania that showed that the majority of respondents were unaware of larviciding (17). This was attributed to the fact that larviciding programmes were limited and restricted to urban areas hence rural people were unaware of it.…”

Cost of microbial larviciding for malaria control in rural Tanzania

“…Another consideration is community acceptability and the societal costs of community engagement. Community support for larviciding was high at baseline in the study area . During implementation, community‐level involvement included optional attendance at annual meetings convened by staff to share information on programme activities, and donated time from community members related to their engagement in study activities (offering information about locating and accessing breeding sites, providing consent as necessary).…”

“…Microbial larviciding, a form of larval source management (LSM), may be a valuable supplement to conventional vector control measures . A recent Cochrane Review concluded that LSM may reduce malaria morbidity in areas in which a majority of breeding sites can be accessed, but added that more research is necessary to evaluate the feasibility of LSM in rural areas where breeding sites are large or numerous .…”

“…israelensis ( Bti ), in rural Mvomero, Tanzania. Bti , a commonly used active ingredient in microbial larviciding, is safe for both humans and the environment . This study seeks to inform policymakers in designing malaria control programmes for rural areas where malaria persists despite high levels of mosquito net usage.…”