Abstract
BackgroundRadical cure of the Plasmodium vivax latent liver stage is required to effectively manage vivax malaria. Targeted mass treatment with primaquine may be an effective mechanism for reducing reservoirs of the disease. Since community engagement and high coverage are essential for mass treatment programs, this study aimed to determine the acceptability of mass primaquine treatment in a targeted community in a northern Myanmar township.MethodsA cross-sectional mixed-methods study was deployed among household leaders in July 2019. Face-to-face interviews using structured questionnaires and standardized qualitative guidelines were conducted to gather information. Descriptive and inferential statistics, including logistic regression models, were applied.ResultsAmong 609 study respondents, > 90% agreed to participate in an upcoming targeted mass primaquine treatment (TPT) program. Factors contributing to higher odds of acceptability of the program were older age [adjusted odds ratios (aOR): 2.38, 95% confidence intervals (CI) 1.08–8.96], secondary education level (aOR: 3.99, 95% CI 1.12–20.01), having good knowledge of malaria (aOR: 2.12, 95% CI 1.04–4.76), experiencing malaria within the family (aOR: 1.92, 95% CI 1.14–5.13), and believing eliminating malaria from the village is possible (aOR: 2.83, 95% CI 1.07–4.07). Furthermore, 50 community respondents, 6 midwives, and 4 public health staff (grade II) participated in the qualitative component of the study. Many thought that TPT seemed feasible and stressed that high coverage of underserved groups and health education are needed before commencing the activity.ConclusionsMost respondents agreed to participate in the proposed mass treatment campaign. Older people with secondary education level and those who had experienced malaria within their families were most likely to report willingness to participate. These same individuals may be important in the community engagement process to increase community acceptance of the program.Graphical abstract
Highlights
Radical cure of the Plasmodium vivax latent liver stage is required to effectively manage vivax malaria
The results of this study will be used to inform the implementation of targeted mass primaquine treatment (TPT) first in a limited study setting, and, if the results indicate that the intervention is safe and effective, it will be scaled up as a general public health tool for malaria elimination
Respondents who were older (≥ 51 years old), had secondary education, had higher than the mean understanding of malaria, had family members who had experienced a malaria infection, and believed that malaria could be eliminated from their village all reported that they would participate in the TPT
Summary
Radical cure of the Plasmodium vivax latent liver stage is required to effectively manage vivax malaria. Targeted mass treatment with primaquine may be an effective mechanism for reducing reservoirs of the disease. Plasmodium falciparum remains the dominant parasite species globally, but in the Southeast Asia region, P. vivax is increasingly the most prevalent malaria species [1, 2]. Nations with both P. falciparum and P. vivax malaria that are trying to eliminate malaria tend to find a persistent P. vivax burden as P. falciparum cases decrease. At least one study suggests that most P. vivax cases (3 in 4 patients) result from relapses rather than new infections [3]. No diagnostic test for detecting liver-stage parasites is available [6]
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