Community acceptability, participation, and adherence to mass drug administration with primaquine for Plasmodium vivax elimination in Southern Thailand: a mixed methods approach

• Published in: Malaria Journal
• Main Authors: Sayambhu Saita, Wanlapa Roobsoong, Patthanasak Khammaneechan, Phnom Sukchan, Saranath Lawpoolsri, Jetsumon Sattabongkot, Liwang Cui, Kamolnetr Okanurak, Suparat Phuanukoonnon, Daniel M. Parker
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: Acceptability; Mass drug administration; Primaquine; Malaria elimination; Mixed-methods; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-023-04443-3; https://doaj.org/article/c8f4fb34a79a4494bc5202fb83064361

Abstract Background Mass drug administration (MDA) with primaquine (PQ) is being considered for accelerating Plasmodium vivax elimination in remaining active foci. This study aimed to determine the acceptability of MDA with PQ in malaria endemic villages in a malarious setting in the South of Thailand undergoing MDA with PQ. Methods A cross-sectional mixed-methods approach was conducted in seven malaria endemic villages where MDA with PQ was implemented. The data were collected from community villagers and health workers using structured questionnaires, in-depth interviews, and focus group discussions. Descriptive statistics and logistic regression models were used for quantitative data analysis. Thematic analysis was applied for qualitative data. Results Among a total of 469 participants from the MDA villages, 293 participants were eligible for MDA with PQ and 79.86% (234) completed 14-days of PQ. The logistic regressions indicated that males (adjusted odds ratio: 2.52 [95% confidence interval: 1.33–4.81]) and those who are farmers (2.57 [1.12–5.90]) were most likely to participate in the MDA. Among 293 participants in the post-MDA study, 74.06% had originally agreed to participate in the MDA with PQ while 25.94% had originally reported not wanting to participate in the MDA. Of those who originally reported being willing to participate in the MDA, 71.23% followed through with participation in the first or second round. Conversely, 93.24% of those who originally reported not being willing to participate in the MDA did in fact participate in the MDA. Factors contributing to higher odds of agreeing to participate and following through with participation included being male (1.98 [1.06–3.69]) and correctly responding that malaria is preventable (2.32 [1.01–5.35]) with some differences by village. Five key themes emerged from the qualitative analyses: concern about side effects from taking PQ; disbelief that malaria could be eliminated in this setting; low overall concern about malaria infections; misunderstandings ...