Community-based malaria control in southern Malawi: a description of experimental interventions of community workshops, house improvement and larval source management

• Published in: Malaria journal Vol. 17; no. 1; p. 266
• Main Authors: van den Berg, Henk, van Vugt, Michèle, Kabaghe, Alinune N, Nkalapa, Mackenzie, Kaotcha, Rowlands, Truwah, Zinenani, Malenga, Tumaini, Kadama, Asante, Banda, Saidon, Tizifa, Tinashe, Gowelo, Steven, Mburu, Monicah M, Phiri, Kamija S, Takken, Willem, McCann, Robert S
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 16.07.2018; BioMed Central; BMC
• Subjects: Aedes aegypti; Analysis; Animals; Annual cycles; Anopheles; Citizen participation; Committees; Community participation; Community Participation - statistics & numerical data; Community workshops; Control; Diagnosis; Disease prevention; Evaluation; Health education; House improvement; Houses; Housing; Human diseases; Humans; Insecticides; Integrated vector management; Intervention; Larva; Larval source management; Malaria; Malaria - prevention & control; Malaria transmission; Malawi; Medical diagnosis; Methodology; Mosquito Control - methods; Mosquito Vectors; Mosquitoes; Poaching; Public health; Removal; Residential areas; Rural areas; Rural Population; Statistics; Systematic review; Training; Uptake; Vector control; Vector-borne diseases; Vectors; Villages; Water treatment; Wildlife; Malawi; Cuba; Vietnam; Tanzania; Vector control; Community workshops; Community participation; House improvement; Malaria transmission; Integrated vector management; Larval source management; Health education
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-018-2415-1

Increased engagement of communities has been emphasized in global plans for malaria control and elimination. Three interventions to reinforce and complement national malaria control recommendations were developed and applied within the context of a broad-based development initiative, targeting a rural population surrounding a wildlife reserve. The interventions, which were part of a 2-year research trial, and assigned to the village level, were implemented through trained local volunteers, or 'health animators', who educated the community and facilitated collective action. Community workshops on malaria were designed to increase uptake of national recommendations; a manual was developed, and training of health animators conducted, with educational content and analytical tools for a series of fortnightly community workshops in annual cycles at village level. The roll-back malaria principle of diagnosis, treatment and use of long-lasting insecticidal nets was a central component of the workshops. Structural house improvement to reduce entry of malaria vectors consisted of targeted activities in selected villages to mobilize the community into voluntarily closing the eaves and screening the windows of their houses; the project provided wire mesh for screening. Corrective measures were introduced to respond to field challenges. Committees were established at village level to coordinate the house improvement activities. Larval source management (LSM) in selected villages consisted of two parts: one on removal of standing water bodies by the community at large; and one on larviciding with bacterial insecticide Bacillus thuringiensis israelensis by trained village committees. Community workshops on malaria were implemented as 'core intervention' in all villages. House improvement and LSM were implemented in addition to community workshops on malaria in selected villages. Three novel interventions for community mobilization on malaria prevention and control were described. The interventions comprised local organizational structure, education and collective action, and incorporated elements of problem identification, planning and evaluation. These methods could be applicable to other countries and settings.