Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam

Abstract Background The effectiveness of malaria prevention with long-lasting insecticidal nets and indoor residual spraying is limited by emerging insecticide resistance, evasive mosquito behaviours that include outdoor biting, sub-optimal implementation and inappropriate use. New vector control in...

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Main Authors: Christina Makungu, Stephania Stephen, Salome Kumburu, Nicodem J. Govella, Stefan Dongus, Zoe Jane-Lara Hildon, Gerry F. Killeen, Caroline Jones
Format: Article
Language:English
Published: BMC 2017-10-01
Series:Malaria Journal
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12936-017-2056-9
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author Christina Makungu
Stephania Stephen
Salome Kumburu
Nicodem J. Govella
Stefan Dongus
Zoe Jane-Lara Hildon
Gerry F. Killeen
Caroline Jones
author_facet Christina Makungu
Stephania Stephen
Salome Kumburu
Nicodem J. Govella
Stefan Dongus
Zoe Jane-Lara Hildon
Gerry F. Killeen
Caroline Jones
author_sort Christina Makungu
collection DOAJ
description Abstract Background The effectiveness of malaria prevention with long-lasting insecticidal nets and indoor residual spraying is limited by emerging insecticide resistance, evasive mosquito behaviours that include outdoor biting, sub-optimal implementation and inappropriate use. New vector control interventions are required and their potential effectiveness will be enhanced if existing household perceptions and practices are integrated into intervention design. Methods This qualitative descriptive study used focus groups discussions, in-depth interviews and photovoice methods to explore mosquito control perceptions and practices among residents in four study sites in Dar es Salaam, Tanzania. Results Mosquitoes were perceived as a growing problem, directly attributed to widespread environmental deterioration and lack of effective mosquito control interventions. Malaria and nuisance biting were perceived as the main problem caused by mosquitoes. Breeding sites were clearly distinguished from resting sites but residents did not differentiate between habitats producing malaria vector mosquitoes and others producing mostly nuisance mosquitoes. The most frequently mentioned protection methods in the wealthiest locations were bed nets, aerosol insecticide sprays, window screens, and fumigation, while bed nets were most frequently mentioned and described as ‘part of the culture’ in the least wealthy locations. Mosquito-proofed housing was consistently viewed as desirable, but considered unaffordable outside wealthiest locations. Slapping and covering up with clothing were most commonly used to prevent biting outdoors. Despite their utility outdoors, topical repellents applied to the skin were considered expensive, and viewed with suspicion due to perceived side effects. Improving the local environment was the preferred method for preventing outdoor biting. Affordability, effectiveness, availability, practicality, as well as social influences, such as government recommendations, socialization and internalization (familiarization and habit) were described as key factors influencing uptake. Conclusions Outdoor transmission is widely accepted as an obstacle to malaria elimination. Larval source management, targeting both malaria vectors and nuisance-biting mosquitoes, is the preferred method for mosquito control among the residents of Dar es Salaam and should be prioritized for development alongside new methods for outdoor personal protection. Even if made available, effective and affordable, these additional interventions may require time and user experience to achieve positive reputations and trustworthiness.
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spelling doaj.art-6bce29483c504212b687b901290c060c2022-12-22T01:40:36ZengBMCMalaria Journal1475-28752017-10-0116111810.1186/s12936-017-2056-9Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es SalaamChristina Makungu0Stephania Stephen1Salome Kumburu2Nicodem J. Govella3Stefan Dongus4Zoe Jane-Lara Hildon5Gerry F. Killeen6Caroline Jones7Environmental Health and Ecological Sciences Department, Ifakara Health InstituteEnvironmental Health and Ecological Sciences Department, Ifakara Health InstituteEnvironmental Health and Ecological Sciences Department, Ifakara Health InstituteEnvironmental Health and Ecological Sciences Department, Ifakara Health InstituteEnvironmental Health and Ecological Sciences Department, Ifakara Health InstituteEnvironmental Health and Ecological Sciences Department, Ifakara Health InstituteEnvironmental Health and Ecological Sciences Department, Ifakara Health InstituteKEMRI-Wellcome Trust Research ProgrammeAbstract Background The effectiveness of malaria prevention with long-lasting insecticidal nets and indoor residual spraying is limited by emerging insecticide resistance, evasive mosquito behaviours that include outdoor biting, sub-optimal implementation and inappropriate use. New vector control interventions are required and their potential effectiveness will be enhanced if existing household perceptions and practices are integrated into intervention design. Methods This qualitative descriptive study used focus groups discussions, in-depth interviews and photovoice methods to explore mosquito control perceptions and practices among residents in four study sites in Dar es Salaam, Tanzania. Results Mosquitoes were perceived as a growing problem, directly attributed to widespread environmental deterioration and lack of effective mosquito control interventions. Malaria and nuisance biting were perceived as the main problem caused by mosquitoes. Breeding sites were clearly distinguished from resting sites but residents did not differentiate between habitats producing malaria vector mosquitoes and others producing mostly nuisance mosquitoes. The most frequently mentioned protection methods in the wealthiest locations were bed nets, aerosol insecticide sprays, window screens, and fumigation, while bed nets were most frequently mentioned and described as ‘part of the culture’ in the least wealthy locations. Mosquito-proofed housing was consistently viewed as desirable, but considered unaffordable outside wealthiest locations. Slapping and covering up with clothing were most commonly used to prevent biting outdoors. Despite their utility outdoors, topical repellents applied to the skin were considered expensive, and viewed with suspicion due to perceived side effects. Improving the local environment was the preferred method for preventing outdoor biting. Affordability, effectiveness, availability, practicality, as well as social influences, such as government recommendations, socialization and internalization (familiarization and habit) were described as key factors influencing uptake. Conclusions Outdoor transmission is widely accepted as an obstacle to malaria elimination. Larval source management, targeting both malaria vectors and nuisance-biting mosquitoes, is the preferred method for mosquito control among the residents of Dar es Salaam and should be prioritized for development alongside new methods for outdoor personal protection. Even if made available, effective and affordable, these additional interventions may require time and user experience to achieve positive reputations and trustworthiness.http://link.springer.com/article/10.1186/s12936-017-2056-9MosquitoMalariaCommunity perceptionsQualitativePhotovoiceBed net
spellingShingle Christina Makungu
Stephania Stephen
Salome Kumburu
Nicodem J. Govella
Stefan Dongus
Zoe Jane-Lara Hildon
Gerry F. Killeen
Caroline Jones
Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
Malaria Journal
Mosquito
Malaria
Community perceptions
Qualitative
Photovoice
Bed net
title Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
title_full Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
title_fullStr Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
title_full_unstemmed Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
title_short Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam
title_sort informing new or improved vector control tools for reducing the malaria burden in tanzania a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of dar es salaam
topic Mosquito
Malaria
Community perceptions
Qualitative
Photovoice
Bed net
url http://link.springer.com/article/10.1186/s12936-017-2056-9
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