“We were afraid of the lion that has roared next to us”; community response to reactive focal mass drug administration for malaria in Eswatini (formerly Swaziland)

摘要: Reactive focal mass drug administration (rfMDA), or presumptive treatment without malaria testing of household members and neighbours a passively identified case, is currently being explored as possible elimination strategy in low transmission settings. One the primary factors determining effectiveness rfMDA on reducing interrupting achieving high coverage target population with administration. This study aims to explore acceptability identify facilitators barriers its potential implementation, well community’s general knowledge, attitudes beliefs regard elimination. A qualitative was performed using focus group discussions (FGDs) among villagers that received through National Malaria Control Programme setting Eswatini part 2-year clinical trial. FGDs were audio-recorded, transcribed translated into English. All transcripts managed Dedoose underwent content analysis. The majority participants perceived their community be at risk malaria. Witnessing others suffer from malaria, proximity Mozambique, various ecological factors, presence mosquitoes contributed this perception. greatest motivator participation witnessing someone else since most had not personally experienced themselves. Participants valued education general, particularly when communicated by nurses other health workers Ministry Health. overwhelmingly motivated participate order obtain protection Most did understand concept sub-clinical infection and, therefore, perceive anti-malarial medication given medication. Perceived for major driver acceptability; future intervention campaigns could aim better quantify inform interventions encourage uptake. There misunderstandings about asymptomatic reservoir parasites humans. Given phenomenon rationale rfMDA, misunderstanding threaten uptake if it persists community. Using local authorities deliver messaging, additional re-inforcement ongoing, even absence frequent cases, may help maximize maintain acceptability.