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Forest work and its implications for malaria elimination: a qualitative study.

Nou Sanann1,2, Thomas J Peto3,4, Rupam Tripura1,5

  • 1Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Malaria Journal
|November 28, 2019
PubMed
Summary

Forest workers in Cambodia face malaria risks due to their activities. Improved prevention strategies, including impregnated nets and accessible testing, are crucial for malaria elimination efforts.

Keywords:
EliminationForestGreater Mekong Sub-regionMalariaQualitative

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Area of Science:

  • Global Health
  • Tropical Medicine
  • Public Health Entomology

Background:

  • Malaria incidence has declined in the Greater Mekong Sub-region (GMS) over the past two decades.
  • Artemisinin resistance has accelerated malaria elimination efforts in the GMS.
  • Malaria transmission is increasingly concentrated in forested areas within the GMS.

Purpose of the Study:

  • To describe forest-going activities in north-eastern Cambodia.
  • To examine forest workers' attitudes and experiences regarding malaria prevention and control.
  • To identify potential improvements for malaria control strategies targeting forest-dwelling populations.

Main Methods:

  • Conducted 19 in-depth interviews with forest workers in Stung Treng Province, Cambodia, who had uncomplicated falciparum malaria.
  • Held two focus group discussions with peers of interviewed forest workers.
  • Utilized thematic analysis on audio-recorded, transcribed, and translated interview and focus group data.

Main Results:

  • Forest work, including logging and collecting forest products, is a primary income source, often combined with farming.
  • Workers sleep in unimpregnated hammock nets and are aware of symptomatic malaria but not asymptomatic infection.
  • They employ personal protective measures like long clothing and repellents, and express willingness for self-testing and treatment.

Conclusions:

  • Current malaria control measures require enhancement based on forest workers' behaviors and risk perceptions.
  • Recommendations include targeted distribution of impregnated hammock nets and provision of on-site treatment.
  • Further research into the efficacy and feasibility of malaria prophylaxis for forest workers in the GMS is a priority.