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Title: Mass anti-malarial administration in western Cambodia: a qualitative study of factors affecting coverage
Authors: Christopher Pell
Rupam Tripura
Chea Nguon
Phaikyeong Cheah
Chan Davoeung
Chhouen Heng
Lim Dara
Ma Sareth
Arjen Dondorp
Lorenz Von Seidlein
Thomas J. Peto
University of Amsterdam
Amsterdam Institute for Global Health and Development
Mahidol University
Academic Medical Centre, University of Amsterdam
National Center for Parasitology, Entomology and Malaria Control
Nuffield Department of Clinical Medicine
Battambang Provincial Health Department
Keywords: Immunology and Microbiology
Issue Date: 19-May-2017
Citation: Malaria Journal. Vol.16, No.1 (2017)
Abstract: © 2017 The Author(s). Background: Mass anti-malarial administration has been proposed as a key component of the Plasmodium falciparum malaria elimination strategy in the Greater Mekong sub-Region. Its effectiveness depends on high levels of coverage in the target population. This article explores the factors that influenced mass anti-malarial administration coverage within a clinical trial in Battambang Province, western Cambodia. Methods: Qualitative data were collected through semi-structured interviews and focus group discussions with villagers, in-depth interviews with study staff, trial drop-outs and refusers, and observations in the communities. Interviews were audio-recorded, transcribed and translated from Khmer to English for qualitative content analysis using QSR NVivo. Results: Malaria was an important health concern and villagers reported a demand for malaria treatment. This was in spite of a fall in incidence over the previous decade and a lack of familiarity with asymptomatic malaria. Participants generally understood the overall study aim and were familiar with study activities. Comprehension of the study rationale was however limited. After the first mass anti-malarial administration, seasonal health complaints that participants attributed to the anti-malarial as “side effects” contributed to a decrease of coverage in round two. Staff therefore adapted the community engagement approach, bringing to prominence local leaders in village meetings. This contributed to a subsequent increase in coverage. Conclusion: Future mass anti-malarial administration must consider seasonal disease patterns and the importance of local leaders taking prominent roles in community engagement. Further research is needed to investigate coverage in scenarios that more closely resemble implementation i.e. without participation incentives, blood sampling and free healthcare.
ISSN: 14752875
Appears in Collections:Scopus 2016-2017

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