Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Baltimore, MD, USA.
Malar J. 2013 Jun 13;12:203. doi: 10.1186/1475-2875-12-203.
Intensive malaria control interventions in the United Republic of Tanzania have contributed to reductions in malaria prevalence. Given that malaria control remains reliant upon continued use of long-lasting insecticidal bed nets (LLINs) even when the threat of malaria has been reduced, this qualitative study sought to understand how changes in perceived risk influence LLIN usage, and to explore in more detail the benefits of net use that are unrelated to malaria.
Eleven focus group discussions were conducted in Bukoba Rural district and in Zanzibar Urban West district in late 2011. Participants were males aged 18 and over, females between the ages of 18 and 49, and females at least 50 years old.
The perceived risk of malaria had decreased among the respondents, and malaria control interventions were credited for the decline. Participants cited reductions in both the severity of malaria and in their perceived susceptibility to malaria. However, malaria was still considered a significant threat. Participants' conceptualization of risk appeared to be an important consideration for net use. At the same time, comfort and aspects of comfort (getting a good night's sleep, avoiding biting pests) appeared to play a large role in personal decisions to use nets consistently or not. Barriers to comfort (feeling uncomfortable or trapped; perceived difficulty breathing, or itching/rashes) were frequently cited as reasons not to use a net consistently. While it was apparent that participants acknowledged the malaria-prevention benefits of net use, the exploration of the risk and comfort determinants of net use provides a richer understanding of net use behaviours, particularly in a setting where transmission has fallen and yet consistent net use is still crucial to maintaining those gains.
Future behaviour change communication campaigns should capitalize on the non-malaria benefits of net use that provide a long-term rationale for consistent use even when the immediate threat of malaria transmission has been reduced.
坦桑尼亚联合共和国强化疟疾控制干预措施使疟疾发病率降低。鉴于即使在疟疾威胁降低的情况下，疟疾控制仍依赖于持续使用长效驱虫蚊帐（LLINs），本定性研究旨在了解感知风险的变化如何影响 LLIN 的使用，并更详细地探讨与疟疾无关的蚊帐使用的好处。
2011 年末在布科巴农村区和桑给巴尔市西部区进行了 11 次焦点小组讨论。参与者为 18 岁及以上的男性、18 至 49 岁的女性以及至少 50 岁的女性。
受访者对疟疾的感知风险有所降低，疟疾控制干预措施被认为是导致这一结果的原因。参与者提到疟疾的严重程度和他们对疟疾的易感性都有所降低。然而，疟疾仍被认为是一个重大威胁。参与者对风险的概念化似乎是使用蚊帐的重要考虑因素。同时，舒适和舒适方面（睡个好觉、避免叮咬害虫）似乎在个人是否持续使用蚊帐的决定中起着重要作用。妨碍舒适的因素（感到不舒服或被困；感觉呼吸困难、瘙痒/皮疹）经常被列为不持续使用蚊帐的原因。虽然很明显，参与者承认了使用蚊帐预防疟疾的好处，但对风险和舒适因素的探讨提供了对蚊帐使用行为的更深入理解，特别是在传播已经下降的情况下，仍然需要持续使用蚊帐来保持这些成果。
未来的行为改变传播活动应该利用蚊帐的非疟疾益处，即使在疟疾传播的直接威胁已经降低的情况下，为持续使用提供长期的理由。
