Perceptions About Malaria Among Brazilian Gold Miners in an Amazonian Border Area: Perspectives for Malaria Elimination Strategies

Abstract

BackgroundMining in the Amazon exposes gold miners to various diseases, including malaria, whose control is still a major challenge. The environment of the mines contributes to the proliferation of vector mosquitoes and the precarious housing conditions facilitate transmission of the disease. Understanding gold miners’ perceptions is essential for the formulation of strategies to fight malaria. A qualitative study was carried out in the municipality of Calçoene, which lies in an area bordering French Guiana in the state of Amapá, Brazilian Amazon.MethodsA semi-structured interview was applied to an intentional sample of 29 miners, a number determined by the theoretical saturation criterion. Thematic analysis was adopted to obtain the results and the Cohen's Kappa index was calculated to verify the agreement between observers during coding.ResultsThe agreement between observers was verified by a Cohen's Kappa index of 0.82. Analysis of the interviews showed that gold miners were subjected to prejudice from the community due to forest diseases that they can transmit, and their activities are often associated with crime. When the miners return to their hometown after a period of mining, the urban population blames them for the onset of diseases such as malaria. Most participants in the survey did not know how malaria transmission occurs, and associated its occurrence with contaminated water and food. Participants reported not being afraid of the disease, trusting the diagnosis and available treatment, though this depends on where they are treated. The use of therapeutic resources, such as medicinal plants and medicines acquired in the illegal market, is very common in this population. Despite the challenges identified by the research subjects, they believe that the disease can be controlled or the cases reduced, but there was low acceptability for a possible mass drug administration (MDA) intervention. ConclusionDespite a recent reduction in malaria prevalence in Brazil, there are still vulnerable populations, such as gold miners, who help to perpetuate the existence of the disease in the Amazon. The lack of knowledge regarding how the transmission of malaria occurs, associated with myths regarding this and the use of traditional health practices and illegal drugs for the treatment of the disease without a specific diagnosis, jeopardizes the country’s efforts to eliminate malaria. It is necessary to implement control programs in these populations, especially those who frequently travel around the border region and to remote locations, which are difficult regions for health teams to access, thus hindering diagnostic and treatment actions. For this reason, understanding the perceptions of these individuals as well as their customs, beliefs and lifestyle, can assist in the production of targeted educational material and adoption of strategies in the elimination of malaria in the country.

Impact of Malakit intervention on perceptions, knowledge, attitudes, and practices related to malaria among workers in clandestine gold mines in French Guiana: results of multicentric cross-sectional surveys over time

“…The evolution of gold miners KAP between 2015 and 2019 shows a signi cant decrease in the perception of malaria risk and knowledge about the transmission and symptoms of the disease). Another recent study found similar results among gold miners in the FG/Brazil area 47 . This phenomenon is frequently observed in regions achieving malaria control, due to the reduced contact of the population with the disease 22,48 .…”

“…Therefore, it is essential to raise and maintain awareness and a sustained level of information on malaria in the communities but also among health professionals working with communities 22,23,47,48,54,55 .…”

Risk Factors of Malaria Transmission Dynamics Among Sand Mining Workers in the Kombos West Coast Region, The Gambia

“…Prior research has demonstrated the importance of public health education in the fight against malaria. (33) According to this survey, respondents' general levels of practice, a itude, and understanding about malaria were all rather excellent. (42) Therefore, the deficiencies found by this study must be addressed in health education in order to increase community knowledge of the condition.…”

“…(26) The survey revealed that respondents exhibited diverse living arrangements in relation to their employment, with some residing in close proximity to their workplaces while others opted for on-site accommodations for extended periods. (6,33) Interestingly, certain miners chose to live near mining regions, underscoring the close association between residential proximity and occupational activities. Analysis of mosquito samples collected from the study area identified Anopheles gambiae sensu stricto, Anopheles quadriannulatus, and Anopheles melas as vectors of malaria in the Rural Gambia Regency, affirming their role in disease transmission within the region.…”

Implementation of a Novel Malaria Management Strategy Based on Self-testing and Self-treatment in Remote Areas in the Amazon (Malakit): Confronting a-priori Assumptions With Reality

“…The living and working conditions -long working days, stagnant water due to alluvial gold mining, etc. -of these gold miners are conducive to malaria, which is endemic in the region (10)(11)(12)(13). Identi ed as a reservoir and a barrier to elimination of the disease, this neglected population was addressed by an innovative research project called Malakit (14)(15)(16).…”