Barriers of Malaria Control Interventions in African and Asian communities: A Comparative Meta-Synthesis Study

P. Chandy, M. Rani, D. Nanjunda, A. Chellaperumal, Shanthraman Kalyanaraman
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Abstract

Background: The research about malaria mainly focused on clinical, vector biology, and epidemiology quantitative studies. But the qualitative evidence at the community level remains untouched in high transmission countries. The current paper focuses on the qualitative evidence to explore the behavioral and community health barriers of malaria control interventions at the grassroots level using an inter-continental comparative platform. Therefore, we selected qualitative studies from Asian and African continents which hold major high transmission hotspot areas. Methods: We screened qualitative studies that focused in-depth on the barriers of malaria control measures for meta-synthesis, which were published between 2010 and 2020 in the Asian and African countries. We followed PRISMA guidelines to conduct a literature search on 7 databases and the quality of the articles was assessed by the SRQR guide. We conducted thematic synthesis and quantified the themes to assess the proportion of barriers identified in both continents and highlighted the barriers and recommendations using an explanatory framework. Results: We have selected 8 articles, which studied in-depth perceptions, barriers, and challenges of malaria control interventions in both Asian and African communities. The lack of knowledge on malaria, approaching traditional healers for treatment, and corruption in the distribution of insecticide nets were the major identified barriers in Asian countries, whereas lack of knowledge and noncompliance to drugs due to side effects were the major issues reported in African countries. Conclusion: Meta-synthesis is designed to investigate the common phenomena among diverse settings. In this study, we have attempted to pool the commonalities and contrasts in barriers of malaria control interventions in both countries. The results of the review givefirsthand information to the policymakers for revising strategies and priorities for the malaria elimination goals in both developing countries.
非洲和亚洲社区疟疾控制干预的障碍:一项比较综合研究
背景:目前对疟疾的研究主要集中在临床、媒介生物学和流行病学定量研究等方面。但在高传播国家,社区一级的定性证据仍未得到接触。本论文着重于定性证据,利用洲际比较平台探索基层疟疾控制干预措施的行为和社区健康障碍。因此,我们选择了具有主要高传播热点地区的亚洲和非洲大陆进行定性研究。方法:筛选2010年至2020年在亚非国家发表的深入研究疟疾控制措施障碍的定性研究,进行meta综合。我们按照PRISMA指南对7个数据库进行文献检索,并根据SRQR指南对文章质量进行评估。我们进行了主题综合并对主题进行了量化,以评估在两大洲发现的障碍的比例,并使用解释性框架强调了障碍和建议。结果:我们选择了8篇文章,深入研究了亚洲和非洲社区疟疾控制干预措施的认知、障碍和挑战。亚洲国家查明的主要障碍是缺乏关于疟疾的知识、寻求传统治疗师治疗以及分发杀虫剂网中的腐败行为,而非洲国家报告的主要问题是缺乏知识和由于副作用而不遵守药物。结论:采用综合分析的方法,可以考察不同环境下的常见现象。在这项研究中,我们试图汇总两国疟疾控制干预措施障碍的共性和对比。审查结果为这两个发展中国家的决策者提供了第一手信息,以修订战略和优先事项,实现消除疟疾的目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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