Onyango Truphena, Nuru Khadija, Kazungu Karisa, Wangari Winnie, Chaccour Carlos, Regina Rabinovich N, Mwangangi Joseph, Maia Marta, Jones Caroline
Kenya Medical Research Institute, Centre for Geographic Medicine Research-Coast, Kilifi, Kenya.
ISGlobal, Barcelona, Spain.
Malar J. 2025 Mar 12;24(1):79. doi: 10.1186/s12936-025-05320-x.
Assessing the acceptability of new malaria control interventions in clinical trials can be complex due to the need for strict ethical standards and specific trial procedures. While in-depth interviews and focus group discussions can provide useful insights, a more participatory method of data collection which complements these methods is photovoice. Photovoice offers a unique approach, empowering participants to share their experiences and perceptions on their own terms. Photovoice was employed alongside the BOHEMIA clinical trial (a trial investigating the safety and efficacy of ivermectin mass-drug administration (MDA) for malaria control) to explore participants' views on the trial and the effects of the intervention on individuals and communities.
Two participants from each of five villages involved in the trial (two intervention, three control) were purposively selected and trained on the ethical and technical use of cameras. During the final round of the intervention, participants photographed their trial experiences and the MDA effects. Two picture-sharing discussions were conducted to explore the picture content and reasons for their inclusion.
Both intervention and control groups expressed confidence in the trial procedures, with pictures capturing barcode scanning and health assessments, activities reported to provide reassurance and enhance trust. Photos from both groups showed positive outcomes such as improved appetite and fewer mosquitoes. However, photos from the ivermectin group also showed clearing of jiggers and killing of bed bugs. Images of rashes, described as a negative effect of the MDA, were taken by both groups. Pictures of mosquito breeding sites and sources of intestinal worms were also shared by both groups.
Photovoice provided valuable insights into trial experiences, intervention effects, and revealed unexpected outcomes, such as killing of bedbugs, that warrant deeper exploration. It exposed broader community concerns of the source of malaria and intestinal worms not addressed by either the intervention or local health authorities.
由于需要严格的伦理标准和特定的试验程序，在临床试验中评估新的疟疾控制干预措施的可接受性可能很复杂。虽然深入访谈和焦点小组讨论可以提供有用的见解，但一种补充这些方法的更具参与性的数据收集方法是摄影声音法。摄影声音法提供了一种独特的方法，使参与者能够按照自己的方式分享他们的经历和看法。摄影声音法与BOHEMIA临床试验（一项调查伊维菌素大规模药物给药（MDA）用于疟疾控制的安全性和有效性的试验）一起使用，以探讨参与者对试验的看法以及干预措施对个人和社区的影响。
从参与试验的五个村庄中各有目的地挑选两名参与者（两个干预组，三个对照组），并对他们进行相机伦理和技术使用方面的培训。在干预的最后一轮中，参与者拍摄了他们的试验经历和MDA的效果。进行了两次图片分享讨论，以探讨图片内容及其入选原因。
干预组和对照组都对试验程序表示有信心，图片捕捉到了条形码扫描和健康评估，据报道这些活动能让人安心并增强信任。两组的照片都显示出了积极的结果，如食欲改善和蚊子减少。然而，伊维菌素组的照片还显示了沙蚤的清除和臭虫的杀灭。两组都拍摄了被描述为MDA负面影响的皮疹图像。两组还分享了蚊子繁殖地和肠道蠕虫来源的图片。
摄影声音法为试验经历、干预效果提供了有价值的见解，并揭示了一些意外结果，如臭虫的杀灭，值得进一步探索。它暴露了社区对疟疾和肠道蠕虫来源更广泛的担忧，而干预措施或当地卫生当局都未解决这些问题。
