Opinions of key stakeholders on alternative interventions for malaria control and elimination in Tanzania

Finda, M. F., Christofides, N., Lezaun, J., Tarimo, B., Chaki, P., Kelly, A. H., Kapologwe, N., Kazyoba, P., Emidi, B. and Okumu, F. O. (2020) Opinions of key stakeholders on alternative interventions for malaria control and elimination in Tanzania. Malaria Journal, 19, 164. (doi: 10.1186/s12936-020-03239-z) (PMID:32321534) (PMCID:PMC7178586)

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Malaria control in Tanzania currently relies primarily on long-lasting insecticidal nets and indoor residual spraying, alongside effective case management and behaviour change communication. This study explored opinions of key stakeholders on the national progress towards malaria elimination, the potential of currently available vector control interventions in helping achieve elimination by 2030, and the need for alternative interventions that could be used to supplement malaria elimination efforts in Tanzania. In this exploratory qualitative study, Focus group discussions were held with policy-makers, regulators, research scientists and community members. Malaria control interventions discussed were: (a) improved housing, (b) larval source management, (c) mass drug administration (MDA) with ivermectin to reduce vector densities, (d) release of modified mosquitoes, including genetically modified or irradiated mosquitoes, (e) targeted spraying of mosquito swarms, and (f) spatial repellents. Larval source management and spatial repellents were widely supported across all stakeholder groups, while insecticide-spraying of mosquito swarms was the least preferred. Support for MDA with ivermectin was high among policy makers, regulators and research scientists, but encountered opposition among community members, who instead expressed strong support for programmes to improve housing for poor people in high transmission areas. Policy makers, however, challenged the idea of government-supported housing improvement due to its perceived high costs. Techniques of mosquito modification, specifically those involving gene drives, were viewed positively by community members, policy makers and regulators, but encountered a high degree of scepticism among scientists. Overall, policy-makers, regulators and community members trusted scientists to provide appropriate advice for decision-making. Stakeholder opinions regarding alternative malaria interventions were divergent except for larval source management and spatial repellents, for which there was universal support. MDA with ivermectin, housing improvement and modified mosquitoes were also widely supported, though each faced concerns from at least one stakeholder group. While policy-makers, regulators and community members all noted their reliance on scientists to make informed decisions, their reasoning on the benefits and disadvantages of specific interventions included factors beyond technical efficiency. This study suggests the need to encourage and strengthen dialogue between research scientists, policy makers, regulators and communities regarding new interventions.

Item Type:Articles
Additional Information:This work was supported by the Bill and Melinda Gates Foundation (Grant Number: OPP1177156), Howard Hughes Medical Institute (Grant Number: OPP1099295), and by the ANTI-VeC Network (Grant Number: AVPP0027/1), all awarded to Ifakara Health Institute. LF was also supported through a Consortium for Advanced Research Training grant awarded by Wellcome Trust (Grant No: 087547/Z/08/Z), the Carnegie Corporation of New York [B 8606.R02], and Sida [54100029].
Keywords:Alternative interventions, Malaria control, Malaria elimination, Opinion, Stakeholders, Tanzania.
Glasgow Author(s) Enlighten ID:Okumu, Professor Fredros
Creator Roles:
Okumu, F.Supervision, Writing – review and editing
Authors: Finda, M. F., Christofides, N., Lezaun, J., Tarimo, B., Chaki, P., Kelly, A. H., Kapologwe, N., Kazyoba, P., Emidi, B., and Okumu, F. O.
College/School:College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
Journal Name:Malaria Journal
Publisher:BioMed Central
ISSN (Online):1475-2875
Copyright Holders:Copyright © The Author(s) 2020
First Published:First published in Malaria Journal 19:164
Publisher Policy:Reproduced under a Creative Commons Licence

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
301038Studies on Ecology, Colonization and Genetic Diversity of the Afro-tropical Malaria Vector, Anopheles funestusHeather FergusonBill and Melinda Gates Foundation (GATES)OPP 1177156Institute of Biodiversity, Animal Health and Comparative Medicine