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Research
Ammy Fiadanana NJATOSOA
Aix-Marseille University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7380-8639
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Although it is accepted that long lasting insecticide bed net (LLIN) use is an effective means to prevent malaria, children aged 5 to 15 years do not appear to be sufficiently protected in Madagascar; malaria prevalence is highest in this age group. The purpose of this article is to summarize recent qualitative studies describing LLIN use among children aged 5–15 years and explore options to increase their use in this age group.
Methods
Qualitative data from three anthropological studies on malaria conducted between 2012 and 2016 in 10 districts of Madagascar were analyzed. These studies cover all malaria epidemiological profiles and 10 of the 18 existing ethnic groups in Madagascar. A thematic analysis was conducted on the collected data from semi-structured interviews, direct observation data, and informal interviews.
Results
A total of 192 semi-structured interviews were conducted. LLINs are generally perceived positively because they protect the health and well-being of users. However, regional representations of mosquito nets may contribute to LLIN nonuse by children over 5 years of age including the association between married status and LLIN use, which leads to the refusal of unmarried young men to sleep under LLINs; the custom of covering the dead with a mosquito net, which leads to fear of LLIN use; and taboos governing sleeping spaces for siblings of opposite sexes, which leads to LLIN shortages in households. Children under 5 years of age are known to be the most vulnerable age group for acquiring malaria and therefore are prioritized for LLIN use when there are limited supplies in households. In contrast, children over 5 years of age, who are perceived to be at less risk for malaria, often sleep without LLINs.
Conclusions
Perceptions, social practices and regional beliefs regarding LLINs s and vulnerability to malaria contribute to the nonuse of LLINs among children over 5 years of age in Madagascar. Modifying LLIN policies to account for these factors may increase LLIN use in this age group and reduce disease burden.
Trial registration
Not applicable
Keywords
Malaria, LLIN use, children overfive, sociocultural factors, Madagascar
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at Malaria Journal.
No community comments so far
Editorial decision: Minor Revision
On 28 Feb, 2021
Review #2 received
Received 23 Feb, 2021
Reviewer #2 agreed
On 14 Feb, 2021
Reviewer #1 agreed
On 06 Feb, 2021
Review #1 received
Received 06 Feb, 2021
Reviewers invited
Invitations sent on 02 Feb, 2021
Editor assigned
On 01 Feb, 2021
Submission checks complete
On 01 Feb, 2021
Editor invited
On 01 Feb, 2021
Version 1
Posted 24 Aug, 2020
No comments provided
Editorial decision: Major Revision
On 23 Nov, 2020
Review #1 received
Received 25 Sep, 2020
Review #2 received
Received 25 Sep, 2020
Reviewer #2 agreed
On 15 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Reviewers invited
Invitations sent on 12 Sep, 2020
Editor assigned
On 20 Aug, 2020
First submitted
On 19 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at Malaria Journal.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Ammy Fiadanana NJATOSOA
Aix-Marseille University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7380-8639
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Malaria Journal.
No community comments so far
Editorial decision: Minor Revision
On 28 Feb, 2021
Review #2 received
Received 23 Feb, 2021
Reviewer #2 agreed
On 14 Feb, 2021
Reviewer #1 agreed
On 06 Feb, 2021
Review #1 received
Received 06 Feb, 2021
Reviewers invited
Invitations sent on 02 Feb, 2021
Editor assigned
On 01 Feb, 2021
Submission checks complete
On 01 Feb, 2021
Editor invited
On 01 Feb, 2021
Version 1
Posted 24 Aug, 2020
No comments provided
Editorial decision: Major Revision
On 23 Nov, 2020
Review #1 received
Received 25 Sep, 2020
Review #2 received
Received 25 Sep, 2020
Reviewer #2 agreed
On 15 Sep, 2020
Reviewer #1 agreed
On 14 Sep, 2020
Reviewers invited
Invitations sent on 12 Sep, 2020
Editor assigned
On 20 Aug, 2020
First submitted
On 19 Aug, 2020
Submission checks complete
On 19 Aug, 2020
Editor invited
On 19 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Malaria Journal.
Background
Although it is accepted that long lasting insecticide bed net (LLIN) use is an effective means to prevent malaria, children aged 5 to 15 years do not appear to be sufficiently protected in Madagascar; malaria prevalence is highest in this age group. The purpose of this article is to summarize recent qualitative studies describing LLIN use among children aged 5–15 years and explore options to increase their use in this age group.
Methods
Qualitative data from three anthropological studies on malaria conducted between 2012 and 2016 in 10 districts of Madagascar were analyzed. These studies cover all malaria epidemiological profiles and 10 of the 18 existing ethnic groups in Madagascar. A thematic analysis was conducted on the collected data from semi-structured interviews, direct observation data, and informal interviews.
Results
A total of 192 semi-structured interviews were conducted. LLINs are generally perceived positively because they protect the health and well-being of users. However, regional representations of mosquito nets may contribute to LLIN nonuse by children over 5 years of age including the association between married status and LLIN use, which leads to the refusal of unmarried young men to sleep under LLINs; the custom of covering the dead with a mosquito net, which leads to fear of LLIN use; and taboos governing sleeping spaces for siblings of opposite sexes, which leads to LLIN shortages in households. Children under 5 years of age are known to be the most vulnerable age group for acquiring malaria and therefore are prioritized for LLIN use when there are limited supplies in households. In contrast, children over 5 years of age, who are perceived to be at less risk for malaria, often sleep without LLINs.
Conclusions
Perceptions, social practices and regional beliefs regarding LLINs s and vulnerability to malaria contribute to the nonuse of LLINs among children over 5 years of age in Madagascar. Modifying LLIN policies to account for these factors may increase LLIN use in this age group and reduce disease burden.
Trial registration
Not applicable
Figure 1
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