Determinants of the use of insecticide-treated bed nets on islands of pre- and post-malaria elimination: an application of the health belief model in Vanuatu

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• 作者：Noriko Watanabe (1)
  Akira Kaneko (1) (2)
  Sam Yamar (3)
  Hope Leodoro (3)
  George Taleo (3)
  Takeo Tanihata (4)
  J Koji Lum (5)
  Peter S Larson (6) (7)
  
  1. Department of Parasitology ; Osaka City University Graduate School of Medicine ; Osaka ; Japan
  2. Department of Microbiology ; Tumor and Cell Biology ; Karolinska Institutet ; Stockholm ; Sweden
  3. Ministry of Health ; Port Vila ; Vanuatu
  4. Department of Infectious Disease Control ; Healthcare Center of Kobe ; Kobe ; Japan
  5. Departments of Anthropology and Biological Sciences ; Binghamton University ; Binghamton ; NY ; USA
  6. Nagasaki University Institute of Tropical Medicine ; Nagasaki ; Japan
  7. University of Michigan School of Natural Resources and Environment ; 440 Church Street ; Ann Arbor ; MI ; USA
  
• 关键词：Malaria ; Insecticide ; treated net (ITN) ; The Health Belief Model (HBM) ; Motivation ; Sustainability ; Malaria elimination ; Islands ; Aneityum ; Ambae
• 刊名：Malaria Journal
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：13
• 期：1
• 全文大小：662 KB
• 参考文献：World Malaria Report 2013. World Health Organization, Geneva
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• 刊物主题：Parasitology; Infectious Diseases; Tropical Medicine;
• 出版者：BioMed Central
• ISSN：1475-2875

文摘

Background Insecticide-treated nets (ITNs) are an integral piece of any malaria elimination strategy, but compliance remains a challenge and determinants of use vary by location and context. The Health Belief Model (HBM) is a tool to explore perceptions and beliefs about malaria and ITN use. Insights from the model can be used to increase coverage to control malaria transmission in island contexts. Methods A mixed methods study consisting of a questionnaire and interviews was carried out in July 2012 on two islands of Vanuatu: Ambae Island where malaria transmission continues to occur at low levels, and Aneityum Island, where an elimination programme initiated in 1991 has halted transmission for several years. Results For most HBM constructs, no significant difference was found in the findings between the two islands: the fear of malaria (99%), severity of malaria (55%), malaria-prevention benefits of ITN use (79%) and willingness to use ITNs (93%). ITN use the previous night on Aneityum (73%) was higher than that on Ambae (68%) though not statistically significant. Results from interviews and group discussions showed that participants on Ambae tended to believe that risk was low due to the perceived absence of malaria, while participants on Aneityum believed that they were still at risk despite the long absence of malaria. On both islands, seasonal variation in perceived risk, thermal discomfort, costs of replacing nets, a lack of money, a lack of nets, nets in poor condition and the inconvenience of hanging had negative influences, while free mass distribution with awareness campaigns and the malaria-prevention benefits had positive influences on ITN use. Conclusions The results on Ambae highlight the challenges of motivating communities to engage in elimination efforts when transmission continues to occur, while the results from Aneityum suggest the possibility of continued compliance to malaria elimination efforts given the threat of resurgence. Where a high degree of community engagement is possible, malaria elimination programmes may prove successful.