Preventing malaria in the Peruvian Amazon: a qualitative study in Iquitos, Peru

• Published in: Malaria Journal
• Main Authors: Ian Newell, Connie Wiskin, James Anthoney, Graciela Meza, Gilles de Wildt
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2018
• Subjects: Malaria; Prevention; Qualitative; Bed nets; Indoor residual spraying; Space spraying; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-018-2177-9; https://doaj.org/article/077e6799bfc145f9a2369173e834a367

Abstract Background In Peru, despite decades of concerted control efforts, malaria remains a significant public health burden. Peru has recently exhibited a dramatic rise in malaria incidence, impeding South America’s progress towards malaria elimination. The Amazon basin, in particular the Loreto region of Peru, has been identified as a target for the implementation of intensified control strategies, aiming for elimination. No research has addressed why vector control strategies in Loreto have had limited impact in the past, despite vector control elsewhere being highly effective in reducing malaria transmission. This study employed qualitative methods to explore factors limiting the success of vector control strategies in the region. Methods Twenty semi-structured interviews were conducted among adults attending a primary care centre in Iquitos, Peru, together with 3 interviews with key informants (health care professionals). The interviews focussed on how local knowledge, together with social and cultural attitudes, determined the use of vector control methods. Results Five themes emerged. (a) Participants believed malaria to be embedded within their culture, and commonly blamed this for a lack of regard for prevention. (b) They perceived a shift in mosquito biting times to early evening, rendering night-time use of bed nets less effective. (c) Poor preventive practices were compounded by a consensus that malaria prevention was the government’s responsibility, and that this reduced motivation for personal prevention. (d) Participants confused the purpose of space-spraying. (e) Participants’ responses also exposed persisting misconceptions, mainly concerning the cause of malaria and best practices for its prevention. Conclusion To eliminate malaria from the Americas, region-specific strategies need to be developed that take into account the local social and cultural contexts. In Loreto, further research is needed to explore the potential shift in biting behaviour of Anopheles darlingi, and how this interacts ...