Center for the Study of Complex Malaria in India

印度复杂疟疾研究中心

基本信息

批准号：
10379252
负责人：
JANE M CARLTON
金额：
$ 103.04万
依托单位：
NEW YORK UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-07-01 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10379252
关键词：
Address Adopted Adoption Adult Affect Area Attitude Awareness Behavior Belief Caring Clinic Communities Complement Complex Culicidae Data Diagnosis Diffusion Disease Education Effectiveness Epidemiology Face Focus Groups Fostering Funding Goals Grant Health Health Personnel Health system Household India Indigenous Infection Insecticides Intervention Interview Knowledge Life Style Malaria Malaria prevention Maps Measures Methods Names Network-based Observational Study Parents Pathway Analysis Perception Persons Policy Maker Prevention Preventive measure Public Health Recommendation Reporting Research Design Residual state Resistance Sampling Side Site Social Behavior Social Network Surveys behavior change design epidemiology study ethnographic method improved member preventive intervention programs social social structure tool trend uptake vector

项目摘要

STUDY TYPE 2: SUMMARY The goal of this project is to conduct mixed methods, social network-based, socio-behavioral studies to determine what types of malaria-preventive interventions reduce malaria through good coverage and use, and to identify demand and/or supply side barriers to malaria control measures in the northeastern state of Meghalaya, India. In this area the malaria situation is dynamic. Cases steadily increased from 2012-2015, but since then there has been a downward trend, and 2017 had the fewest cases ever reported. This steep decline has been attributed to the distribution of long-lasting insecticide impregnated bednets (LLINs) in 2016 and partial adoption of indoor residual spraying (IRS) with DDT. Nevertheless, residual cases remain endemic, and to design an appropriate elimination strategy, we must try to understand the reasons for these cases. Data from the Meghalaya Department of Health Malaria Division and from the Center for the Study of Complex Malaria in India (CSCMi) ongoing epidemiology studies suggest that community resistance to IRS, misuse of LLINs, unprotected outdoor activity, and hidden reservoirs of asymptomatic, submicroscopic, and hypnozoite infections all contribute to the endemic persistence of malaria. At Barato PHC (primary health center) and Nonglang PHC in Meghalaya, 10 villages in each site will be subjects of epidemiological studies funded through the parent CSCMi 2.0 grant. In Aim 1 we plan to examine how malaria-preventive measures are adopted in practice, using ethnographic methods of non-participant observations; in Aim 2 we will explore the cultural and social barriers preventive measures may face, using qualitative interviews and focus group discussions (FGDs); and in Aim 3 we will assess which community members are most likely to influence villagers to accept or reject such measures, using social network analysis surveys. When these Aims have been concluded, their findings will be summarized and integrated with those of other CSCMi studies (epidemiology, vector) underway at the Barato and Nonglang PHCs into a malaria situation analysis for the villages involved. This will yield a better understanding of the focal malaria epidemiology, as well as barriers and opportunities to current interventions used (e.g., LLINs, IRS), and possibilities for additional interventions (e.g., treatment of household members of malaria cases). It will also enable us to provide recommendations to the state malaria control program for additional measures that are likely to foster or improve the effectiveness of IRS and LLINs, with the long-term objective of complete elimination of malaria in Meghalaya.

研究类型 2：总结该项目的目标是进行混合方法、基于社交网络的社会行为研究确定哪些类型的疟疾预防干预措施可以通过良好的覆盖和使用来减少疟疾，以及确定东北部州疟疾控制措施的需求和/或供应方面的障碍印度梅加拉亚邦。该地区的疟疾形势不断变化。 2012年至2015年案件数量稳步增加，但此后呈下降趋势，2017 年报告的病例数是有史以来最少的。这种急剧下降归因于 2016 年分发长效杀虫剂浸渍蚊帐 (LLIN) 和部分采用滴滴涕室内滞留喷洒（IRS）。尽管如此，残留病例仍然流行，为了设计适当的消除策略，我们必须尝试了解这些情况的原因。数据来自梅加拉亚邦卫生部疟疾司和复杂研究中心印度疟疾 (CSCMi) 正在进行的流行病学研究表明，社区对 IRS 的抵制、滥用 LLIN、无保护的户外活动以及无症状、亚微观和催眠子的隐藏储存库感染都会导致疟疾的持续流行。在 Barato PHC（初级保健中心）和梅加拉亚邦 Nonglang PHC，每个地点的 10 个村庄将成为流行病学研究的对象通过父级 CSCMi 2.0 资助。在目标 1 中，我们计划研究疟疾预防措施的效果如何在实践中采用非参与观察的人种学方法；在目标 2 中，我们将探索使用定性访谈和焦点小组，预防措施可能面临的文化和社会障碍讨论（FGD）；在目标 3 中，我们将评估哪些社区成员最有可能产生影响使用社交网络分析调查村民接受或拒绝此类措施。当这些目标有了得出结论后，他们的研究结果将被总结并与其他 CSCMi 研究的结果相结合 Barato 和 Nonglang 初级保健中心正在进行（流行病学、媒介）疟疾形势分析涉及的村庄。这将有助于更好地了解局灶性疟疾流行病学以及障碍当前使用的干预措施的机会（例如，LLIN、IRS），以及额外干预措施的可能性（例如，治疗疟疾病例的家庭成员）。它还将使我们能够提供建议国家疟疾控制计划可能促进或提高有效性的额外措施 IRS 和 LLIN 的长期目标是彻底消除梅加拉亚邦的疟疾。