Community perceptions of targeted anti-malarial mass drug administrations in two provinces in Vietnam: a quantitative survey

Abstract

BackgroundAs part of a targeted malaria elimination project, mass drug administrations (MDAs) were conducted in Vietnam. The impact of MDAs on malaria transmission depends largely on the efficacy of the anti-malarial drug regimen, the malaria epidemiology in the site and the population coverage. To explore why some people participate in MDAs and others do not, a quantitative survey of the villagers’ perceptions was undertaken in Vietnam.MethodsIn 2013/2014 MDAs were conducted in a village in Binh Phuoc province and a village in Ninh Thuan province. Within three months of the drug administration, 59 respondents in a village in Binh Phuoc and 79 respondents in a village in Ninh Thuan were randomly selected and interviewed.ResultsComprehension of the purpose of the intervention was of paramount importance for participation in the intervention. Respondents aware that the intervention aims to protect against malaria were significantly more likely to participate than respondents who were unaware of the MDA’s purpose. Secondly, how and by whom villagers were informed was critical for participation. There was a strong association between sensitization by an informant such as a member of the local health team with participation in the intervention.ConclusionsThe study suggests several approaches to increase participation in mass drug administration campaigns. Training trustworthy informants to sensitize the study population is critical to maximize village participation in this setting. To achieve high coverage the entire community must understand and agree with the intervention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1662-2) contains supplementary material, which is available to authorized users.

Factors associated with population coverage of targeted malaria elimination (TME) in southern Savannakhet Province, Lao PDR

“…Others who could not complete the participation (n = 9), gave reasons such as travelling, busy due to work and adverse events due to the medicine. Such explanations are consistent with those offered for partial or non-participation in past MDAs in the Gambia [ 19 – 21 ], Vietnam [ 14 ] and the Thai–Myanmar border regions [ 9 ]. The villagers’ reasons for partial or non-participation were discussed in meetings, and those who voiced concerns about MDA were sought out and provided with additional health education during house-to-house visits [ 16 ].…”

“…The questionnaire was adapted from a version used to assess the same factors in diverse settings, including The Gambia [ 20 ], Thai-Myanmar border [ 9 ] and Vietnam [ 14 ]. The questionnaire was translated, pre-tested and checked for clarity, language and comprehensibility with Laotian researchers at Laos-Oxford Mahosot Wellcome Trust Research Unit in Vientiane, then with 20 respondents in Vientiane, and finally at the Nong District headquarter with local household heads (n = 6).…”

“…To date, several questionnaire-based studies have examined the factors that influence coverage of mass anti-malarial administration [ 9 , 14 ]. These studies found that investments in providing information to villagers through trustworthy informants were essential to increase participation.…”

Elements of effective community engagement: lessons from a targeted malaria elimination study in Lao PDR (Laos)

“…For example, explaining the rationale for taking antimalarials when asymptomatic can be difficult because of the complex scientific concepts that underlie the approach [7]. Furthermore, target communities are often remote with poor access, villagers tend to be highly mobile and populations can be divided by political affiliations [8–12]. …”

Mass drug administrations with dihydroartemisinin-piperaquine and single low dose primaquine to eliminate Plasmodium falciparum have only a transient impact on Plasmodium vivax: Findings from randomised controlled trials

“…Data were collected through community-wide surveys at baseline, and then every three months. Surveys were preceded by a community census to re-enumerate the study population and to provide intensive community engagement in order to improve high coverage [10][11][12][13][14]. Information collected included demographics, bednet use, duration of stay in the forest, and adverse events.…”