Malaria care-seeking and treatment ideation among gold miners in Guyana

Abstract

Background Although miners are a priority population in malaria elimination in Guyana, scant literature exists on the drivers of malaria-related behaviour. This study explores the relationship between gold miners’ malaria-related ideation and the adoption of malaria care-seeking and treatment behaviours including prompt care-seeking, malaria testing, and self-medication. Methods Data are from a cross-sectional quantitative survey of 1685 adult miners between the ages of 18–59 years who live in mining camps in Regions 1, 7, and 8. The analysis focused on miners who reported an episode of fever in the past year (n = 745). Malaria care-seeking and treatment ideation was defined as a composite additive score consisting of the following variables: general malaria knowledge, perceived severity, perceived susceptibility, beliefs, perceived self-efficacy, perceived norms, interpersonal communication, and perceived response efficacy. Multivariable logistic regressions explored the relationship between ideation on care-seeking/treatment behaviours, controlling for confounding variables. Results Most miners with a recent episode of fever had perceived risk (92%), self-efficacy (67%), susceptibility (53%) and high malaria knowledge (53%). Overall, miners' care-seeking/treatment ideation score ranged from 0 to 8 with a mean of 4.1. Ideation scores were associated with higher odds of care-seeking for fever (aOR: 1.19; 95% CI 1.04–1.36), getting tested for malaria (aOR: 1.22; 95% CI 1.07–1.38) and lower odds of self-medication (aOR: 0.87; 95% CI 0.77–0.99). Conclusions A national community case management initiative is using study findings as part of its scale-up, using volunteers to make testing and treatment services more accessible to miners. This is complemented by a multi-channel mass media campaign to improve miners’ ideation. Communication messages focus on increasing miners’ knowledge of malaria transmission and symptoms, encourage positive beliefs about malaria testing and volunteer testers, promote evidence about the effectiveness of testing, and reminders of how quick and easy it is to get a malaria test with the community case management initiative. Study findings also have implications for efforts to eliminate malaria across the Guiana Shield.

The Role of Human Behavior in Plasmodium knowlesi Malaria Infection: A Systematic Review

“…The understanding of human–vector contact patterns, and how they overlap in time and space, enables a more accurate representation of disease exposure [ 27 , 32 ]. Other factors such as social norms, perceived behavioral control, motivation to perform the behavior, and psychological factors such as attitude towards the preventive behavior and emotions, can play a role in malaria exposure [ 47 , 48 , 49 ]. Social context and behavioral factors are among the known attributes of community perceptions and behavioral practices on antimalarial preventive measures [ 29 ].…”

“…As a result, these anthropogenic activities threaten the biodiversity and impact a higher risk of zoonotic malaria exposure as both monkeys and mosquitoes get closer to humans [ 2 , 6 , 11 , 12 , 40 ]. It is clear that P. knowlesi control is challenging, thus, individuals and communities need to culturally adapt to preventative measures, have sufficient knowledge about the issues, develop a positive attitude toward adopting health-supportive behaviors, gain support from and interact with others, and feel good about performing the behaviors [ 47 , 48 , 49 ]. Stakeholders must provide support to ensure a multi-collaborative effort in controlling this vector-borne disease [ 51 ], for example, by improving the housing structures, designing an innovative tool to avoid mosquito bites, and implementing the One Health approach [ 52 ].…”

“…Malaria control strategies, especially those involving community education, should be tailored to fit each community depending on these factors [ 28 , 51 ]. Health promotion utilizing effective communication aids in preventive action should be considered, but such communication must be suited to the social context of the community [ 47 , 48 , 49 ]. A carefully designed malaria control program should consider the socio and behavior change (SBC) of the communities’ beliefs, drivers, facilitators, and motivation towards malaria preventive behavior.…”

Exploring the key anthropological drivers of and barriers to zoonotic malaria preventative behaviour in a community exposed to Plasmodium knowlesi infection in Malaysia: protocol for a qualitative study with a participatory research design

“…33 36 The model acts as a conceptual tool that can identify common psychosocial variables that may influence malaria-related behaviour. [37][38][39] This framework identifies a set of psychosocial variables grouped into three domains: cognitive, social support and emotion. 33 For example, cognitive variables or factors include the attitude towards the recommended preventive behaviour, perceived risk and self-efficacy to avoid malaria infection, while emotion could describe the feelings of fear towards malaria infection.…”

“…Social support variables or factors embrace the community support and peer pressure to practice or avoid the recommended preventive behaviour. [37][38][39] The explanatory model is a tool for medical and public health professionals to investigate cultural variations in illness experiences, diagnosis and treatment. 34 The model aids in developing rapid assessments through direct communication with patients, family members and relatives.…”