Department of Public Health Sciences, Queen's University, 62 Fifth Field Company Lane, Kingston, ON, K7L3N6, Canada.
Burma Medical Association, Mae Sot, Thailand.
Malar J. 2021 Apr 20;20(1):195. doi: 10.1186/s12936-021-03733-y.
Multi-pronged malaria elimination strategies are increasingly being considered for accelerating efforts against malaria transmission in Southeast Asia. Two malaria prevention interventions used in in the region are insecticide-treated bed-nets (ITNs) and mass drug administration (MDA). Universal access to ITNs is recommended and high population coverage (e.g. above 80%) is needed during MDA initiatives to maximize the impact of these interventions. However, variability in ITN use and individual MDA participation exists. This systematic review aims to provide a summary and overview of literature discussing factors influencing uptake of these two malaria control strategies in Southeast Asian countries.
A search of OVID Embase, OVID MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, OpenGrey, ProQuest, and Google Scholar was undertaken in February 2020. English-language publications with any study design using data from any of the ten member countries of the Association of Southeast Asian Nations were eligible for inclusion. In addition, reference lists of identified articles were manually searched. Websites for relevant international agencies were also searched to identify related grey literature.
The review identified thirty publications that met the inclusion and exclusion criteria. Most discussed ITN use (n = 18) and were relevant to populations in Myanmar (n = 14). All MDA studies were published after 2016, whereas included ITN studies spanned from 1998 to 2020. Seven main themes emerged across the studies. Knowledge of malaria and attitudes towards ITNs were emphasized as key factors associated with ITN use. For MDA participation, key factors included the importance of positive attitudes towards the program, the influence of indirect costs and incentives, and the tendency for group decision-making.
As countries in Southeast Asia continue to work towards becoming malaria-free by 2030, the knowledge and attitudes of local population sub-groups should be assessed and incorporated into the planning and implementation of malaria prevention activities. The role of incentives and group decision making should also be considered particularly as they relate to MDA. There is need for ongoing involvement of health educators, the continuation of implementation research and the prioritization of community engagement efforts alongside malaria interventions in the region.
在东南亚，越来越多的人开始考虑采用多管齐下的疟疾消除策略来加速疟疾传播的防控工作。该地区使用的两种疟疾预防干预措施是经杀虫剂处理的蚊帐（ITN）和大规模药物治疗（MDA）。建议普及 ITN 的使用，并且在 MDA 计划期间需要高人群覆盖率（例如，超过 80%），以最大限度地发挥这些干预措施的效果。然而，ITN 的使用和个人 MDA 的参与存在差异。本系统评价旨在提供一份文献综述，概述讨论影响东南亚国家采用这两种疟疾控制策略的因素。
我们于 2020 年 2 月对 OVID Embase、OVID MEDLINE、Cochrane 中央对照试验注册库、Web of Science、OpenGrey、ProQuest 和 Google Scholar 进行了检索。符合纳入和排除标准的英文出版物，无论研究设计如何，只要使用来自东南亚国家联盟十个成员国之一的数据，均可纳入研究。此外，还对已确定文章的参考文献进行了手工检索。还对相关国际机构的网站进行了搜索，以确定相关灰色文献。
该综述共确定了 30 篇符合纳入和排除标准的出版物。其中大多数（n=18）讨论了 ITN 的使用情况，且与缅甸（n=14）的人群相关。所有 MDA 研究都是在 2016 年后发表的，而纳入的 ITN 研究则跨越了 1998 年至 2020 年。研究中有七个主要主题。对疟疾的认识和对 ITN 的态度被强调为与 ITN 使用相关的关键因素。对于 MDA 的参与，关键因素包括对项目的积极态度、间接成本和激励的影响以及群体决策的倾向。
随着东南亚各国继续努力在 2030 年之前实现无疟疾，应评估当地人群亚组的知识和态度，并将其纳入疟疾预防活动的规划和实施中。还应考虑激励措施和群体决策的作用，特别是与 MDA 相关的激励措施和群体决策的作用。需要持续让健康教育工作者参与进来，继续进行实施研究，并在该地区的疟疾干预措施之外，优先考虑社区参与工作。
