Abstract
BackgroundSlash and burn cultivators are a significant risk group for malaria in South-East Asia. As envisaged in the National Strategic Plan for Malaria Elimination, Bangladesh aims to achieve zero indigenous malaria transmission by 2030. For the national plan to move from malaria control to malaria elimination, targeting the population of slash and burn cultivators is of overriding importance.MethodsThe study used an explorative mixed method design to investigate the knowledge, attitudes, and practices (KAP) regarding malaria prevention and treatment in an endemic area of Bangladesh. Adult slash and burn cultivators in two sub-districts of the Rangamati District were selected and interviewed. Four focus group discussions were conducted, and this was followed by a cross-sectional quantitative survey with 200 participants.ResultsThe respondents’ general knowledge about malaria transmission and modes of prevention and treatment was good. However, there were some gaps regarding knowledge about specific aspects of malaria transmission and in particular about the increased risk associated with their occupation. Despite a much-reduced incidence of malaria in the study area, the respondents perceived the disease as life-threatening and knew that it needs rapid attention from a health worker. Moreover, the specific services offered by the local community health workers for malaria diagnosis and treatment were highly appreciated. Finally, the use of insecticide-treated mosquito nets (ITN) was considered as important and this intervention was uniformly stated as the main malaria prevention method.ConclusionsThe findings from this study on promising KAP characteristics in the slash and burn cultivator population are reassuring that the goal of malaria elimination by the year 2030 can be achieved in Bangladesh.
Highlights
Slash and burn cultivators are a significant risk group for malaria in South-East Asia
Qualitative findings Sociodemographic information Four focus group discussions (FGD) took place, which included a total of 24 adult slash and burn cultivators, 12 females and 12 males, and all belonging to the Chakma Tribal group
They clean the hilly areas to gain fields, they plant the seeds for respective crops, and they sleep near the ground even during rains
Summary
Slash and burn cultivators are a significant risk group for malaria in South-East Asia. As envisaged in the National Strategic Plan for Malaria Elimination, Bangladesh aims to achieve zero indigenous malaria transmission by 2030. For the national plan to move from malaria control to malaria elimination, targeting the population of slash and burn cultivators is of overriding importance. The increased spending by the international health community has helped in significantly reducing the malaria incidence and mortality over the last 15 years, nearly half the world population still lives in malaria-endemic areas [2]. Bangladesh is situated in southern Asia and bordered by malaria-endemic areas of India and Myanmar. Malaria transmission currently occurs in 13 districts of Bangladesh, which represent 9% of the overall population of 160 million in 2015 (Fig. 1). A total of 39,719 malaria cases were reported in Bangladesh in 2015 and falciparum malaria accounted for 81% of them [Ministry
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