Skip to main content
Top
Published in: Malaria Journal 1/2015

Open Access 01-12-2015 | Research

A qualitative study of perceptions of a mass test and treat campaign in Southern Zambia and potential barriers to effectiveness

Authors: Kafula Silumbe, Elizabeth Chiyende, Timothy P Finn, Michelle Desmond, Chilunga Puta, Busiku Hamainza, Mulakwa Kamuliwo, David A Larsen, Thomas P Eisele, John Miller, Adam Bennett

Published in: Malaria Journal | Issue 1/2015

Login to get access

Abstract

Background

A mass test and treat campaign (MTAT) using rapid diagnostic tests (RDTs) and artemether-lumefantrine (AL) was conducted in Southern Zambia in 2012 and 2013 to reduce the parasite reservoir and progress towards malaria elimination. Through this intervention, community health workers (CHWs) tested all household members with rapid diagnostic tests (RDTs) and provided treatment to those that tested positive.

Methods

A qualitative study was undertaken to understand CHW and community perceptions regarding the MTAT campaign. A total of eight focus groups and 33 in-depth and key informant interviews were conducted with CHWs, community members and health centre staff that participated in the MTAT.

Results

Interviews and focus groups with CHWs and community members revealed that increased knowledge of malaria prevention, the ability to reach people who live far from health centres, and the ability of the MTAT campaign to reduce the malaria burden were the greatest perceived benefits of the campaign. Conversely, the primary potential barriers to effectiveness included refusals to be tested, limited adherence to drug regimens, and inadequate commodity supply. Study respondents generally agreed that MTAT services were scalable outside of the study area but would require greater involvement from district and provincial medical staff.

Conclusions

These findings highlight the importance of increased community sensitization as part of mass treatment campaigns for improving campaign coverage and acceptance. Further, they suggest that communication channels between the Ministry of Health, National Malaria Control Centre and Medical Stores Limited may need to be improved so as to ensure there is consistent supply and management of commodities. Continued capacity building of CHWs and health facility supervisors is critical for a more effective programme and sustained progress towards malaria elimination.
Literature
1.
go back to reference Chizema-Kawesha E, Miller JM, Steketee RW, Mukonka VM, Mukuka C, Mohamed AD, et al. Scaling up malaria control in Zambia: progress and impact 2005–2008. Am J Trop Med Hyg. 2010;83:480–8.CrossRefPubMedCentralPubMed Chizema-Kawesha E, Miller JM, Steketee RW, Mukonka VM, Mukuka C, Mohamed AD, et al. Scaling up malaria control in Zambia: progress and impact 2005–2008. Am J Trop Med Hyg. 2010;83:480–8.CrossRefPubMedCentralPubMed
2.
go back to reference Zambia Ministry of Health, N.M.C.C. National Malaria Control Programme Strategic Plan 2011-2015. 2012: Lusaka, Zambia Zambia Ministry of Health, N.M.C.C. National Malaria Control Programme Strategic Plan 2011-2015. 2012: Lusaka, Zambia
3.
go back to reference Kern SE, Tiono AB, Makanga M, Gbadoe AD, Premji Z, Gaye O, et al. Community screening and treatment of asymptomatic carriers of Plasmodium falciparum with artemether-lumefantrine to reduce malaria disease burden: a modelling and simulation analysis. Malar J. 2011;10:210.CrossRefPubMedCentralPubMed Kern SE, Tiono AB, Makanga M, Gbadoe AD, Premji Z, Gaye O, et al. Community screening and treatment of asymptomatic carriers of Plasmodium falciparum with artemether-lumefantrine to reduce malaria disease burden: a modelling and simulation analysis. Malar J. 2011;10:210.CrossRefPubMedCentralPubMed
4.
go back to reference Okell LC, Ghani AC, Lyons E, Drakeley CJ. Submicroscopic infection in Plasmodium falciparum-endemic populations: a systematic review and meta-analysis. J Infect Dis. 2009;200:1509–17.CrossRefPubMed Okell LC, Ghani AC, Lyons E, Drakeley CJ. Submicroscopic infection in Plasmodium falciparum-endemic populations: a systematic review and meta-analysis. J Infect Dis. 2009;200:1509–17.CrossRefPubMed
5.
go back to reference Larsen DA, Bennett A, Silumbe K, Hamainza B, Yukich JO, Keating J, et al.: Population-wide malaria testing and treatment with rapid diagnostic tests and artemether-lumefantrine in Southern Zambia: a community randomized step-wedge control trial design. Am J Trop Med Hyg 2015, [Epub ahead of print]. Larsen DA, Bennett A, Silumbe K, Hamainza B, Yukich JO, Keating J, et al.: Population-wide malaria testing and treatment with rapid diagnostic tests and artemether-lumefantrine in Southern Zambia: a community randomized step-wedge control trial design. Am J Trop Med Hyg 2015, [Epub ahead of print].
6.
go back to reference Tiono AB, Ouedraogo A, Ogutu B, Diarra A, Coulibaly S, Gansane A, et al. A controlled, parallel, cluster-randomized trial of community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso. Malar J. 2013;12:79.CrossRefPubMedCentralPubMed Tiono AB, Ouedraogo A, Ogutu B, Diarra A, Coulibaly S, Gansane A, et al. A controlled, parallel, cluster-randomized trial of community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso. Malar J. 2013;12:79.CrossRefPubMedCentralPubMed
7.
go back to reference De Martin S, von Seidlein L, Deen JL, Pinder M, Walraven G, Greenwood B. Community perceptions of a mass administration of an antimalarial drug combination in the Gambia. Trop Med Int Health. 2001;6:442–8.CrossRefPubMed De Martin S, von Seidlein L, Deen JL, Pinder M, Walraven G, Greenwood B. Community perceptions of a mass administration of an antimalarial drug combination in the Gambia. Trop Med Int Health. 2001;6:442–8.CrossRefPubMed
8.
go back to reference Okello G, Ndegwa SN, Halliday KE, Hanson K, Brooker SJ, Jones C. Local perceptions of intermittent screening and treatment for malaria in school children on the south coast of Kenya. Malar J. 2012;11:185.CrossRefPubMedCentralPubMed Okello G, Ndegwa SN, Halliday KE, Hanson K, Brooker SJ, Jones C. Local perceptions of intermittent screening and treatment for malaria in school children on the south coast of Kenya. Malar J. 2012;11:185.CrossRefPubMedCentralPubMed
9.
go back to reference Zambia Ministry of Health NMCC. Zambia National Malaria Indicator Survey 2010. Zambia: Lusaka; 2011. Zambia Ministry of Health NMCC. Zambia National Malaria Indicator Survey 2010. Zambia: Lusaka; 2011.
10.
go back to reference Littrell M, Miller JM, Ndhlovu M, Hamainza B, Hawela M, Kamuliwo M, et al. Documenting malaria case management coverage in Zambia: a systems effectiveness approach. Malar J. 2013;12:371.CrossRefPubMedCentralPubMed Littrell M, Miller JM, Ndhlovu M, Hamainza B, Hawela M, Kamuliwo M, et al. Documenting malaria case management coverage in Zambia: a systems effectiveness approach. Malar J. 2013;12:371.CrossRefPubMedCentralPubMed
11.
go back to reference Patton MQ. Qualitative Research & Evaluation Methods. Thousand Oaks, California: SAGE Publications; 2002. Patton MQ. Qualitative Research & Evaluation Methods. Thousand Oaks, California: SAGE Publications; 2002.
12.
go back to reference Friese S. User’s Manual for Atlas.ti, version 7.0 (software). Berlin, Germany: Scientific Software Development GmbH; 2012. Friese S. User’s Manual for Atlas.ti, version 7.0 (software). Berlin, Germany: Scientific Software Development GmbH; 2012.
13.
go back to reference Comoe CC, Ouattara AF, Raso G, Tanner M, Utzinger J, Koudou BG. Willingness to use a rapid diagnostic test for malaria in a rural area of central Cote d'Ivoire. BMC Publ Health. 2012;12:1089.CrossRef Comoe CC, Ouattara AF, Raso G, Tanner M, Utzinger J, Koudou BG. Willingness to use a rapid diagnostic test for malaria in a rural area of central Cote d'Ivoire. BMC Publ Health. 2012;12:1089.CrossRef
14.
go back to reference Boahen O, Owusu-Agyei S, Febir LG, Tawiah C, Tawiah T, Afari S, et al. Community perception and beliefs about blood draw for clinical research in Ghana. Trans R Soc Trop Med Hyg. 2013;107:261–5.CrossRefPubMed Boahen O, Owusu-Agyei S, Febir LG, Tawiah C, Tawiah T, Afari S, et al. Community perception and beliefs about blood draw for clinical research in Ghana. Trans R Soc Trop Med Hyg. 2013;107:261–5.CrossRefPubMed
15.
go back to reference Nchito M, Geissler PW, Mubila L, Friis H, Olsen A. Effects of iron and multimicronutrient supplementation on geophagy: a two-by-two factorial study among Zambian schoolchildren in Lusaka. Trans R Soc Trop Med Hyg. 2004;98:218–27.CrossRefPubMed Nchito M, Geissler PW, Mubila L, Friis H, Olsen A. Effects of iron and multimicronutrient supplementation on geophagy: a two-by-two factorial study among Zambian schoolchildren in Lusaka. Trans R Soc Trop Med Hyg. 2004;98:218–27.CrossRefPubMed
16.
go back to reference Chanda P, Hamainza B, Moonga HB, Chalwe V, Pagnoni F. Community case management of malaria using ACT and RDT in two districts in Zambia: achieving high adherence to test results using community health workers. Malar J. 2011;10:158.CrossRefPubMedCentralPubMed Chanda P, Hamainza B, Moonga HB, Chalwe V, Pagnoni F. Community case management of malaria using ACT and RDT in two districts in Zambia: achieving high adherence to test results using community health workers. Malar J. 2011;10:158.CrossRefPubMedCentralPubMed
17.
go back to reference Counihan H, Harvey SA, Sekeseke-Chinyama M, Hamainza B, Banda R, Malambo T, et al. Community health workers use malaria rapid diagnostic tests (RDTs) safely and accurately: results of a longitudinal study in Zambia. Am J Trop Med Hyg. 2012;87:57–63.CrossRefPubMedCentralPubMed Counihan H, Harvey SA, Sekeseke-Chinyama M, Hamainza B, Banda R, Malambo T, et al. Community health workers use malaria rapid diagnostic tests (RDTs) safely and accurately: results of a longitudinal study in Zambia. Am J Trop Med Hyg. 2012;87:57–63.CrossRefPubMedCentralPubMed
18.
go back to reference Ruizendaal E, Dierickx S, Peeters Grietens K, Schallig HD, Pagnoni F, Mens PF. Success or failure of critical steps in community case management of malaria with rapid diagnostic tests: a systematic review. Malar J. 2014;13:229.CrossRefPubMedCentralPubMed Ruizendaal E, Dierickx S, Peeters Grietens K, Schallig HD, Pagnoni F, Mens PF. Success or failure of critical steps in community case management of malaria with rapid diagnostic tests: a systematic review. Malar J. 2014;13:229.CrossRefPubMedCentralPubMed
19.
go back to reference Mukanga D, Tibenderana JK, Kiguli J, Pariyo GW, Waiswa P, Bajunirwe F, et al. Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda. Malar J. 2010;9:203.CrossRefPubMedCentralPubMed Mukanga D, Tibenderana JK, Kiguli J, Pariyo GW, Waiswa P, Bajunirwe F, et al. Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda. Malar J. 2010;9:203.CrossRefPubMedCentralPubMed
20.
go back to reference Lemma H, Lofgren C, San Sebastian M. Adherence to a six-dose regimen of artemether-lumefantrine among uncomplicated Plasmodium falciparum patients in the Tigray Region. Ethiopia Malar J. 2011;10:349.CrossRef Lemma H, Lofgren C, San Sebastian M. Adherence to a six-dose regimen of artemether-lumefantrine among uncomplicated Plasmodium falciparum patients in the Tigray Region. Ethiopia Malar J. 2011;10:349.CrossRef
21.
go back to reference Krentel A, Fischer PU, Weil GJ. A review of factors that influence individual compliance with mass drug administration for elimination of lymphatic filariasis. PLoS Negl Trop Dis. 2013;7, e2447.CrossRefPubMedCentralPubMed Krentel A, Fischer PU, Weil GJ. A review of factors that influence individual compliance with mass drug administration for elimination of lymphatic filariasis. PLoS Negl Trop Dis. 2013;7, e2447.CrossRefPubMedCentralPubMed
22.
go back to reference Roy RN, Sarkar AP, Misra R, Chakroborty A, Mondal TK, Bag K. Coverage and awareness of and compliance with mass drug administration for elimination of lymphatic filariasis in Burdwan District, West Bengal, India. J Health Popul Nutr. 2013;31:171–7.CrossRefPubMedCentralPubMed Roy RN, Sarkar AP, Misra R, Chakroborty A, Mondal TK, Bag K. Coverage and awareness of and compliance with mass drug administration for elimination of lymphatic filariasis in Burdwan District, West Bengal, India. J Health Popul Nutr. 2013;31:171–7.CrossRefPubMedCentralPubMed
23.
go back to reference Okello G, Jones C, Bonareri M, Ndegwa SN, McHaro C, Kengo J, et al. Challenges for consent and community engagement in the conduct of cluster randomized trial among school children in low income settings: experiences from Kenya. Trials. 2013;14:142.CrossRefPubMedCentralPubMed Okello G, Jones C, Bonareri M, Ndegwa SN, McHaro C, Kengo J, et al. Challenges for consent and community engagement in the conduct of cluster randomized trial among school children in low income settings: experiences from Kenya. Trials. 2013;14:142.CrossRefPubMedCentralPubMed
24.
go back to reference Dial NJ, Ceesay SJ, Gosling RD, D'Alessandro U, Baltzell KA. A qualitative study to assess community barriers to malaria mass drug administration trials in the Gambia. Malar J. 2014;13:47.CrossRefPubMedCentralPubMed Dial NJ, Ceesay SJ, Gosling RD, D'Alessandro U, Baltzell KA. A qualitative study to assess community barriers to malaria mass drug administration trials in the Gambia. Malar J. 2014;13:47.CrossRefPubMedCentralPubMed
Metadata
Title
A qualitative study of perceptions of a mass test and treat campaign in Southern Zambia and potential barriers to effectiveness
Authors
Kafula Silumbe
Elizabeth Chiyende
Timothy P Finn
Michelle Desmond
Chilunga Puta
Busiku Hamainza
Mulakwa Kamuliwo
David A Larsen
Thomas P Eisele
John Miller
Adam Bennett
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2015
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-015-0686-3

Other articles of this Issue 1/2015

Malaria Journal 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.