Hutchins Harry, Power Grace, Ant Thomas, Teixeira da Silva Eunice, Goncalves Adriana, Rodrigues Amabelia, Logan James, Mabey David, Last Anna
London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK.
Malar J. 2020 Nov 17;19(1):412. doi: 10.1186/s12936-020-03469-1.
Malaria remains a significant public health problem in Guinea-Bissau, West Africa. Government control measures include bed net distribution campaigns, however, local knowledge, attitudes and practices towards bed nets and malaria are uncharacterized on the remote Bijagos Archipelago.
Knowledge, attitude and practice questionnaires were conducted with household heads, aiming to explore the understanding of malaria and factors influencing bed net uptake and usage. Nets were observed in situ to appraise net quality and behaviour. All 14 villages and one semi-urban neighbourhood on Bubaque Island were included. One in 5 households containing school-aged children were randomly selected.
Of 100 participants, 94 were aware of malaria and 66 of those considered it a significant or severe problem, primarily because of its impact on health and income. Transmission, symptoms and risk factors were well known, however, 28.0% of participants felt under-informed. Some 80.0% reported contact with distribution campaigns, with inter-village variability. Campaign contact was associated with feeling well informed (OR 3.44; P = 0.024) and inversely with perceiving malaria a household (OR 0.18; P = 0.002) or regional problem (OR 0.25; P = 0.018). Every household contained nets; every identifiable example was a long-lasting insecticide-treated net (LLIN), however, 23.0% of households contained at least one expired net. Replacements were in demand; 89.0% of households reported that all residents used nets, and average occupancy was 2.07 people per net; 65.2% stated that the repurposing of bed nets was common. Correctly using bed nets, defined by age, integrity and demonstration, was 35.0% and strongly associated with completing intermittent preventative treatment in pregnancy (RR 3.63; P = 0.014).
Knowledge of malaria is good in these communities. Bed nets are used widely and are valued for their role in preventing malaria. However, their use is frequently sub-optimal and offers a target for improving malaria control by adapting popular distribution campaigns to provide more education alongside fresh LLINs. The impact of this could be significant as LLINs represent the mainstay of malaria prevention in Guinea-Bissau; however, the persistence of malaria despite the high uptake of LLINs seen in this study suggests that novel supplementary approaches must also be considered.
疟疾仍是西非几内亚比绍的一个重大公共卫生问题。政府的控制措施包括开展蚊帐分发活动，然而，在偏远的比热戈斯群岛，当地对蚊帐和疟疾的认知、态度及做法尚不明确。
对户主进行了关于知识、态度和做法的问卷调查，旨在探究对疟疾的了解以及影响蚊帐使用和采纳的因素。在实地观察蚊帐，以评估蚊帐质量和使用行为。纳入了布巴克岛上的所有14个村庄和一个半城市社区。随机抽取了五分之一有学龄儿童的家庭。
在100名参与者中，94人知晓疟疾，其中66人认为这是一个重大或严重问题，主要是因为其对健康和收入的影响。传播、症状和风险因素广为人知，然而，28.0%的参与者觉得信息不足。约80.0%的人报告接触过分发活动，不同村庄存在差异。接触活动与感觉信息充分相关（比值比3.44；P = 0.024），与将疟疾视为家庭（比值比0.18；P = 0.002）或地区问题（比值比0.25；P = 0.018）呈负相关。每个家庭都有蚊帐；每个可识别的蚊帐都是长效驱虫蚊帐（LLIN），然而，23.0%的家庭至少有一顶过期蚊帐。需要更换蚊帐；89.0%的家庭报告所有居民都使用蚊帐，平均每顶蚊帐居住2.07人；65.2%的人表示重新利用蚊帐很常见。按照年龄、完整性和示范定义的正确使用蚊帐的比例为35.0%，且与孕期完成间歇性预防治疗密切相关（相对危险度3.63；P = 0.014）。
这些社区对疟疾的了解程度良好。蚊帐被广泛使用，并因其在预防疟疾中的作用而受到重视。然而，其使用往往未达到最佳效果，通过调整流行的分发活动，在提供新的长效驱虫蚊帐的同时提供更多教育，可为改善疟疾控制提供一个目标。这可能会产生重大影响，因为长效驱虫蚊帐是几内亚比绍疟疾预防的主要手段；然而，尽管本研究中长效驱虫蚊帐的使用率很高，但疟疾仍然持续存在，这表明还必须考虑新的补充方法。
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