Academic journal article Iranian Journal of Public Health

Community Perceptions and Practices about Malaria Prevention and Control in Iran

Academic journal article Iranian Journal of Public Health

Community Perceptions and Practices about Malaria Prevention and Control in Iran

Article excerpt


Malaria is one of causes of sickness and death in the developing world; it is responsible for more than a million deaths and around 250 million new cases annually in the world (1-4). Malaria has been demonstrated excessively in several countries in Sub-Sahara, Thailand and India accounting for around 95% of all malaria cases in the world (5-10).

The south eastern areas of Iran including Sistan va Buluchistan Province, Hormozgan Province and the tropical parts of Kerman Province; are considered as malaria regions with a reported Annual Parasite Incidence API ranged from 1 to 8 per 1,000 populations (11). The Ministry of Health and Medical Education in Iran has fo-cused its effort on recommended guidelines by World Health Organization (WHO) (12). Two of these strategies consist of early diagnosis and prompt effective anti-malarial treatment. Admi-nistrators need local-level information to effect-tively direct and guide the programmes of mala-ria so they are responsive to local conditions (13). Operative malaria control is an essential pre-cursor to development in countries (14)

In addition, the initial phase to any action or operative control program is to know about audience awareness about health problem. In this case, to evaluate people awareness about malaria symptom, prevention methods and transmission rout is noticeably important. However, to date no comprehensive national malaria survey has been conducted to identify the coverage of these strat-egies in Iran. Appropriate malaria control strate-gies with emphasis on organizational, economical, and cultural aspects are urgently needed.

Therefore, the present study was conducted to determine at risk people awareness about malaria symptoms, prevention methods, and transmission rout as the initial step to designing effective imple-mentation program.

Materials and Methods

Sample design

In this cluster randomised cross-sectional house-hold survey data were collected from 125 clusters (the size of each cluster was 40 households) in both rural and urban area of malaria affected districts of Iran from Jul 5 to Aug 9, 2009 as follows: Firstly, all the health facilities in the target districts in the three provinces (Sistan va Buluchistan, Hormozgan and Kerman) were listed based on geographical regions and separately for towns and villages and then the populations were calculated cumulatively. Secondly, required sample size divided based on the proportion of population/households in three target regions and in terms of rural or urban residency. Thirdly, clusters and head-clusters (the first selected household as opening point for survey) were determined using systematic random sampling. After that, trained personnel referred to the first household in every cluster and moved on their right side to cover the entire forty households in every cluster.

Survey questionnaire

Using available questionnaires in the website of WHO (15-17), the organizers of this survey deve-loped the questionnaire for the local condition and its completion instructions. Then question-nnaire pretested in the field and its results were discussed in several meetings with the participa-tion of a group of knowledgeable malaria experts from the involved organizations. Afterward, the questionnaires and its completion instructions were revised carefully to fulfil study demands.

Training and field work

Interviewers were trained by a combination course of classroom training and practical experience to know how to perform their task perfectly. Additionally, each interviewer had given a detailed manual, which was designed in accordance with WHO recommendations (15-17) to clarify them how to do their work.

Data management and analysis

Data were collected through direct referring of the trained interviewing teams to the selected households and filling in questionnaires. Each team interviewed 20 families on average every day. Once all the information was collected and cleaned, analysis was done and descriptive statistics (i. …

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