Abstract
BackgroundAlthough miners are a priority population in malaria elimination in Guyana, scant literature exists on the drivers of malaria-related behaviour. This study explores the relationship between gold miners’ malaria-related ideation and the adoption of malaria care-seeking and treatment behaviours including prompt care-seeking, malaria testing, and self-medication.MethodsData are from a cross-sectional quantitative survey of 1685 adult miners between the ages of 18–59 years who live in mining camps in Regions 1, 7, and 8. The analysis focused on miners who reported an episode of fever in the past year (n = 745). Malaria care-seeking and treatment ideation was defined as a composite additive score consisting of the following variables: general malaria knowledge, perceived severity, perceived susceptibility, beliefs, perceived self-efficacy, perceived norms, interpersonal communication, and perceived response efficacy. Multivariable logistic regressions explored the relationship between ideation on care-seeking/treatment behaviours, controlling for confounding variables.ResultsMost miners with a recent episode of fever had perceived risk (92%), self-efficacy (67%), susceptibility (53%) and high malaria knowledge (53%). Overall, miners' care-seeking/treatment ideation score ranged from 0 to 8 with a mean of 4.1. Ideation scores were associated with higher odds of care-seeking for fever (aOR: 1.19; 95% CI 1.04–1.36), getting tested for malaria (aOR: 1.22; 95% CI 1.07–1.38) and lower odds of self-medication (aOR: 0.87; 95% CI 0.77–0.99).ConclusionsA national community case management initiative is using study findings as part of its scale-up, using volunteers to make testing and treatment services more accessible to miners. This is complemented by a multi-channel mass media campaign to improve miners’ ideation. Communication messages focus on increasing miners’ knowledge of malaria transmission and symptoms, encourage positive beliefs about malaria testing and volunteer testers, promote evidence about the effectiveness of testing, and reminders of how quick and easy it is to get a malaria test with the community case management initiative. Study findings also have implications for efforts to eliminate malaria across the Guiana Shield.
Highlights
Miners are a priority population in malaria elimination in Guyana, scant literature exists on the drivers of malaria-related behaviour
In Guyana, multiple Plasmodium species are responsible for malaria transmission; over 60% of the local cases are due to Plasmodium vivax, while Plasmodium falciparum and mixed species cause the rest [1, 5]
The firstline treatment for uncomplicated falciparum malaria in Guyana is a three-day course of artemether-lumefantrine and primaquine, while chloroquine and primaquine taken over 14 days are the treatment for vivax malaria [1]
Summary
Miners are a priority population in malaria elimination in Guyana, scant literature exists on the drivers of malaria-related behaviour. In Guyana, multiple Plasmodium species are responsible for malaria transmission; over 60% of the local cases are due to Plasmodium vivax, while Plasmodium falciparum and mixed species cause the rest [1, 5]. The firstline treatment for uncomplicated falciparum malaria in Guyana is a three-day course of artemether-lumefantrine and primaquine, while chloroquine and primaquine taken over 14 days are the treatment for vivax malaria [1]. These treatments are recommended upon diagnosis of malaria from either microscopy or a rapid diagnostic test (RDT) typically conducted after people with fever or other malaria symptoms seek medical care from a qualified health provider [2]
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