Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore MD3, 16 Medical Drive, 117597, Singapore.
Malar J. 2011 Jul 21;10:199. doi: 10.1186/1475-2875-10-199.
The Timor-Leste Ministry of Health has recently finalized the National Malaria Control Strategy for 2010-2020. A key component of this roadmap is to provide universal national coverage with long-lasting insecticide-treated nets (LLINs) in support of achieving the primary goal of reducing both morbidity and mortality from malaria by 30% in the first three years, followed by a further reduction of 20% by end of the programme cycle in 2020 1. The strategic plan calls for this target to be supported by a comprehensive information, education and communication (IEC) programme; however, there is limited prior research into household and personal usage patterns to assist in the creation of targeted, effective, and socio-culturally specific behaviour change materials.
Nine separate focus group discussions (FGDs) were carried out in Dili, Manatuto, and Covalima districts, Democratic Republic of Timor-Leste, in July 2010.These focus groups primarily explored themes of perceived malaria risk, causes of malaria, net usage patterns within families, barriers to correct and consistent usage, and the daily experience of users (both male and female) in households with at least one net. Comprehensive qualitative analysis utilized open source analysis software.
The primary determinants of net usage were a widespread perception that nets could or should only be used by pregnant women and young children, and the availability of sufficient sleeping space under a limited number of nets within households. Both nuisance biting and disease prevention were commonly cited as primary motivations for usage, while seasonality was not a significant factor. Long-term net durability and ease of hanging were seen as key attributes in net design preference. Very frequent washing cycles were common, potentially degrading net effectiveness. Finally, extensive re-purposing of nets (fishing, protecting crops) was both reported and observed, and may significantly decrease availability of nighttime sleeping space for all family members if distributed nets do not remain within the household.
Emphasizing that net usage is acceptable and important for all family members regardless of age or gender, and addressing the complex behavioural economics of alternative net usages could have significant impacts on malaria control efforts in Timor-Leste, as the country's programmes make progress towards universal net coverage.
东帝汶卫生部最近完成了 2010-2020 年国家疟疾控制战略。该路线图的一个关键组成部分是提供全国范围内普遍使用长效驱虫蚊帐（LLINs），以支持在头三年将疟疾发病率和死亡率降低 30%这一首要目标，然后在 2020 年方案周期结束前再降低 20%。该战略计划要求该目标得到全面的信息、教育和交流（IEC）计划的支持；然而，在创建有针对性、有效和具有社会文化特定的行为改变材料方面，家庭和个人使用模式的前期研究有限。
2010 年 7 月，在东帝汶民主共和国帝力、马纳图托和科瓦利马区进行了九项单独的焦点小组讨论（FGD）。这些焦点小组主要探讨了疟疾风险的感知、疟疾的原因、家庭内蚊帐的使用模式、正确和一致使用的障碍，以及家庭中至少有一个蚊帐的用户（男性和女性）的日常体验等主题。全面的定性分析利用开源分析软件进行。
蚊帐使用的主要决定因素是一种普遍的看法，即蚊帐只能或应该由孕妇和幼儿使用，以及家庭中有限数量的蚊帐下有足够的睡眠空间。被蚊子叮咬和预防疾病都是常见的使用动机，而季节性不是一个重要因素。长期的耐用性和易于悬挂被认为是蚊帐设计偏好的关键属性。经常频繁的洗涤周期很常见，可能会降低蚊帐的效果。最后，广泛的重新定位（捕鱼、保护农作物）既被报道也被观察到，如果分发的蚊帐不在家庭中，可能会显著减少所有家庭成员夜间的睡眠空间。
强调无论年龄或性别如何，蚊帐的使用对所有家庭成员都是可接受和重要的，并解决替代蚊帐使用的复杂行为经济学问题，可能对东帝汶的疟疾控制工作产生重大影响，因为该国的方案正在朝着普遍覆盖蚊帐的目标迈进。
