Social and Behavioural Research Group, Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Kilifi, Kenya.
Malar J. 2012 Jun 8;11:185. doi: 10.1186/1475-2875-11-185.
The intermittent screening and treatment (IST) of school children for malaria is one possible intervention strategy that could help reduce the burden of malaria among school children. Future implementation of IST will not only depend on its efficacy and cost-effectiveness but also on its acceptability to parents of the children who receive IST, as well as those responsible for its delivery. This study was conducted alongside a cluster-randomized trial to investigate local perceptions of school-based IST among parents and other stakeholders on the Kenyan south coast.
Six out of the 51 schools receiving the IST intervention were purposively sampled, based on the prevalence of Plasmodium infection, to participate in the qualitative study. Twenty-two focus group discussions and 17 in-depth interviews were conducted with parents and other key stakeholders involved in the implementation of school health programmes in the district. Data analysis was guided by the framework analysis method.
High knowledge of the burden of clinical malaria on school children, the perceived benefits of preventing clinical disease through IST and previous positive experiences and interactions with other school health programmes facilitated the acceptability of IST. However, lack of understanding of the consequences of asymptomatic parasitaemia for apparently healthy school children could potentially contribute to non-adherence to treatment, and use of alternative anti-malarial drugs with simpler regimens was generally preferred. The general consensus of stakeholders was that health workers were best placed to undertake the screening and provide treatment, and although teachers' involvement in the programme is critical, most participants were opposed to teachers taking finger-prick blood samples from children. There was also a strong demand for the distribution of mosquito nets to augment IST.
School-based malaria control through IST was acceptable to most parents and other stakeholders, but careful consideration of the various roles of teachers, community health workers, and health workers, and the use of anti-malarial drugs with simpler regimens are critical to its future implementation.
间歇性筛查和治疗（IST）是针对学龄儿童疟疾的一种可能的干预策略，有助于降低学龄儿童疟疾负担。未来 IST 的实施不仅取决于其疗效和成本效益，还取决于接受 IST 的儿童家长以及负责实施 IST 的人员的接受程度。本研究是在肯尼亚南部沿海地区开展的一项基于群组的随机试验的同时进行的，旨在调查家长和其他利益相关者对基于学校的 IST 的看法。
根据疟原虫感染的流行率，从接受 IST 干预的 51 所学校中选择了 6 所学校进行有针对性的抽样，参与定性研究。在该地区实施学校卫生项目的家长和其他关键利益相关者中开展了 22 次焦点小组讨论和 17 次深入访谈。数据分析遵循框架分析方法。
高知临床疟疾对学龄儿童的负担，通过 IST 预防临床疾病的预期好处，以及以往与其他学校卫生项目的积极经验和互动，促进了 IST 的可接受性。然而，对无症状寄生虫血症对看似健康的学龄儿童的后果缺乏了解，可能导致治疗不依从，并且通常更倾向于使用方案更简单的替代抗疟药物。利益相关者的普遍共识是，卫生工作者最适合进行筛查和提供治疗，尽管教师参与该项目至关重要，但大多数参与者反对教师从儿童身上采集指血样本。人们强烈要求分发蚊帐来补充 IST。
大多数家长和其他利益相关者都接受通过 IST 进行学校疟疾控制，但需要仔细考虑教师、社区卫生工作者和卫生工作者的各种角色，并使用方案更简单的抗疟药物，这对其未来的实施至关重要。
