The acceptability of mass administrations of anti‑malarial drugs as part of targeted malaria elimination in villages along the Thai–Myanmar border
Background: A targeted malaria elimination project, including mass drug administrations (MDA) of dihydroartemisinin/ piperaquine plus a single low dose primaquine is underway in villages along the Thailand Myanmar border. The intervention has multiple components but the success of the project will...
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Format: | Article |
Language: | English |
Published: |
2017
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Online Access: | https://repository.li.mahidol.ac.th/handle/123456789/2750 |
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Institution: | Mahidol University |
Language: | English |
Summary: | Background: A targeted malaria elimination project, including mass drug administrations (MDA) of dihydroartemisinin/
piperaquine plus a single low dose primaquine is underway in villages along the Thailand Myanmar border.
The intervention has multiple components but the success of the project will depend on the participation of the
entire communities. Quantitative surveys were conducted to study reasons for participation or non-participation in
the campaign with the aim to identify factors associated with the acceptance and participation in the mass drug
administrations.
Methods: The household heads in four study villages in which MDAs had taken place previously were interviewed
between January 2014 and July 2015.
Results: 174/378 respondents (46 %) completed three rounds of three drug doses each, 313/378 (83 %) took at least
three consecutive doses and 56/378 (15 %) did not participate at all in the MDA. The respondents from the two villages
(KNH and TPN) were much more likely to participate in the MDA than respondents from the other two villages
(HKT and TOT). The more compliant villages KNH and TPN had both an appearance of cohesive communities with
similar demographic and ethnic backgrounds. By contrast the villages with low participation were unique. One village
was fragmented following years of armed conflict and many respondents gave little inclination to cooperate with
outsiders. The other village with low MDA coverage was characterised by a high percentage of short-term residents
with little interest in community interventions. A universal reason for non-participation in the MDA applicable to all
villages was an inadequate understanding of the intervention.
Conclusions: It is unlikely that community engagement can unite fragmented communities in participating in an
intervention, which benefits the community. Understanding the purpose and the reasons underlying the intervention
is an important pre-condition for participation. In the absence of direct benefits and a complete understanding of the
indirect benefits trust in the investigators is critical for participation. |
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