Infectious Diseases Research Collaboration, Kampala, Uganda.
London School of Hygiene and Tropical Medicine, London, UK.
Malar J. 2021 Jun 26;20(1):283. doi: 10.1186/s12936-021-03811-1.
Travel is a well-recognized risk factor for malaria. Within sub-Saharan Africa, travellers from areas of lower to higher transmission intensity are potentially at high risk of malaria. Long-lasting insecticidal nets (LLINs) are the primary tool for prevention of malaria, and their widespread use has contributed to substantial reductions in malaria burden. However, travellers often fail to use LLINs. To further explore the challenges and opportunities of using LLINs, travellers were interviewed in Uganda.
In August and September 2019, 20 participants attending outpatient clinics at Naguru General Hospital in Kampala with a history of travel out of Kampala within the previous 60 days were purposively selected. Data were collected through in-depth interviews and analysed thematically using NVivo 12.
Of the 20 participants, 13 were male. Thirteen of the 20 participants tested positive for malaria by microscopy, and 5 reported using of LLINs during travel. The main reasons for travel were to attend social events (weddings, funerals, overnight prayers) and for work. travellers who attended social events reported using LLINs less commonly than those who travelled for work. Challenges to using LLINs during travel included: (1) limited access to LLINs; (2) challenges in planning ahead of travel; (3) lack of space or ability to hang LLINs while travelling; (4) impression that LLINs in lodging places were unhygienic; (5) cultural beliefs discouraging use of LLINs during social events; (6) participation in overnight ceremonies; and (7) doubts about efficacy of LLINs. Positive factors influencing use of LLINs during travel included knowledge regarding malaria prevention and good affordability and availability of LLINs.
Despite good traveller knowledge regarding malaria control measures, use of LLINs was limited. Use of LLINs in the prevention of malaria among travellers from low to high transmission settings needs to be prioritized. This calls for increased behaviour change oriented communication to improve traveller preparedness and consideration of use of repellents in situations where LLINs may not be feasible. The Uganda Ministry of Health and Malaria Control Division should use educational messages to increase awareness about the risks of getting malaria during overnight travel through the media. Truck drivers should be sensitized through their companies to use the available space at the back of the trucks for hanging nets and consider using pop-up nets.
旅行是疟疾公认的危险因素。在撒哈拉以南非洲，从低传播强度地区到高传播强度地区的旅行者都有感染疟疾的高风险。长效驱虫蚊帐（LLINs）是预防疟疾的主要工具，其广泛使用使疟疾负担大大减轻。然而，旅行者往往无法使用 LLINs。为了进一步探讨旅行者使用 LLINs 的挑战和机遇，我们在乌干达对旅行者进行了访谈。
2019 年 8 月至 9 月，在坎帕拉纳加鲁综合医院（Naguru General Hospital）门诊就诊的 20 名旅行者中，选择了 20 名在过去 60 天内曾有过从坎帕拉以外地区旅行经历的旅行者进行有目的的选择。通过深入访谈收集数据，并使用 NVivo 12 进行主题分析。
20 名参与者中，有 13 名男性。20 名参与者中有 13 名经显微镜检查疟原虫阳性，有 5 名报告在旅行中使用了 LLINs。旅行的主要原因是参加社交活动（婚礼、葬礼、通宵祈祷）和工作。参加社交活动的旅行者比因工作旅行的旅行者更不常使用 LLINs。旅行中使用 LLINs 的挑战包括：（1）LLINs 有限；（2）旅行前规划的挑战；（3）旅行时没有空间或能力悬挂 LLINs；（4）认为住宿场所的 LLINs 不卫生；（5）社交活动中不鼓励使用 LLINs 的文化信仰；（6）参加通宵仪式；（7）对 LLINs 疗效的怀疑。影响旅行者旅行时使用 LLINs 的积极因素包括对疟疾预防措施的了解以及 LLINs 的良好可负担性和可用性。
尽管旅行者对疟疾控制措施有很好的了解，但 LLINs 的使用仍然有限。需要优先考虑在从低传播强度地区到高传播强度地区的旅行者中使用 LLINs 来预防疟疾。这需要加强以行为改变为导向的沟通，以提高旅行者的准备程度，并考虑在 LLINs 不可行的情况下使用驱虫剂。乌干达卫生部和疟疾控制司应通过媒体利用教育信息提高人们对夜间旅行中感染疟疾风险的认识。应通过公司提高卡车司机的认识，利用卡车后面的可用空间悬挂蚊帐，并考虑使用弹出式蚊帐。
