Mitchell Elke, Tavui Aminiasi, Andersson Sarah, Lake Susanna, Koroivueti Aminiasi, Koroivueta Josefa, Kaurasi Ripeka, Bechu Vinaisi, Kaldor John, Steer Andrew, Romani Lucia
Kirby Institute, UNSW Sydney, Sydney, Australia.
Melbourne School of Population and Global Heath, Melbourne University, Australia.
Lancet Reg Health West Pac. 2024 Sep 4;51:101194. doi: 10.1016/j.lanwpc.2024.101194. eCollection 2024 Oct.
Fiji has among the highest global reported prevalence of scabies. Mass drug administration (MDA) has been identified as a potentially effective strategy to control scabies, but acceptability of MDA from the perspectives of people receiving and delivering scabies MDA programs remains underexplored in Fiji and globally.
A qualitative study was conducted after completion of the national MDA campaign. Participants included 44 community members and 12 key informants across the Central and Western Divisions of Fiji. Semi-structured face-to-face and virtual interviews were conducted in August and September 2023. An interpretive research approach was adopted, and data were analysed using deductive and inductive techniques.
We identified several barriers and facilitators to scabies MDA acceptability. Facilitators included prior experiences of scabies and knowledge of the potential health benefit of MDA, community attitudes to MDA and neighbours' adherence practices, endorsement of MDA by community leaders, community consultation and exposure to community sensitisation, and involvement of local key informants during planning and implementation. Barriers included a lack of trust in MDA campaigns, religious beliefs, limited reach of community sensitisation, and challenges to implementing MDA in urban locations.
This is the first qualitative study documenting acceptability of a nationwide scabies-MDA globally. It identified diverse socio-structural factors that influenced MDA implementation and acceptability. Future MDA programs could benefit from widespread community sensitisation, tailored approaches to urban and rural MDA design and delivery, and the inclusion of communities in the co-design and implementation of MDA programs.
The National Health and Medical Research Council (NHMRC) investigator grant-LR and the Macquarie Group Foundation 50th Celebration Awards-AS.
据全球报告，斐济的疥疮患病率位居前列。群体药物管理（MDA）已被确定为控制疥疮的一种潜在有效策略，但从接受和实施疥疮MDA项目的人群角度来看，MDA在斐济乃至全球的可接受性仍未得到充分探索。
在全国性MDA活动结束后进行了一项定性研究。参与者包括斐济中部和西部行政区的44名社区成员和12名关键信息提供者。2023年8月和9月进行了半结构化的面对面和虚拟访谈。采用了解释性研究方法，并使用演绎和归纳技术对数据进行了分析。
我们确定了疥疮MDA可接受性的几个障碍和促进因素。促进因素包括疥疮的既往经历以及对MDA潜在健康益处的了解、社区对MDA的态度和邻居的依从做法、社区领袖对MDA的认可、社区咨询和社区宣传活动的参与，以及当地关键信息提供者在规划和实施过程中的参与。障碍包括对MDA活动缺乏信任、宗教信仰、社区宣传活动的覆盖范围有限，以及在城市地区实施MDA面临的挑战。
这是全球第一项记录全国性疥疮MDA可接受性的定性研究。它确定了影响MDA实施和可接受性的各种社会结构因素。未来的MDA项目可能会受益于广泛的社区宣传、针对城乡MDA设计和实施的量身定制方法，以及让社区参与MDA项目的共同设计和实施。
国家卫生与医学研究委员会（NHMRC）研究员资助 - LR以及麦格理集团基金会第50周年庆典奖 - AS。
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