Background
Methods
Study area
Study design and procedures
Ethical aspects
Results
Qualitative findings
Sociodemographic information
Jhum cultivation process and local terminology for malaria
We have to spend around six months in the field starting from April. One month for selection and cleaning the field area and another month for planting seeds in the ground. After that, we have to look after the field continuously. That takes up to six months in total.” Slash and burn cultivator, FGD 02
“…..When we go for our Jhum cultivation work, we build ‘macha’ (a local name for small huts) for staying there overnight, if we have to. We build our little houses there, lay down our bed sheets and sleep there”. Slash and burn cultivator, FGD 02
“No, we call malaria by its original name in here. Sometimes people suffer from fever caused by viruses. But malaria is not known by any other name to our knowledge. In the past, there was a disease named ‘kala-jor’ which also caused suffering to people with fever. However, even then we would call malaria by its name only.” Slash and burn Cultivator, FGD 03
Knowledge about malaria
“Malaria is caused by the biting of mosquito. I mean, if a female mosquito bites one, then they can contract malaria.” Slash and burn Cultivator, FGD 04
“One will have a headache if they have malaria. First, they will have a high fever with chills… After that, for example, they can have seizures. Some people even vomit if the condition gets worse.” Slash and burn Cultivator, FGD 03
“Those, who do work like us (Jhum cultivation), roam in the forests to make a living, they have a higher risk of getting malaria. Those who have a dirty household, have bushes around the house, they can also get malaria easily. As mosquitos breed more often in those places, so the risk of malaria also increases in that kind of houses.” Slash and burn cultivator, FGD 04
Attitude towards malaria
“We forgot about everything because we haven`t seen new cases for so long. The disease does not occur anymore as it used to in the past. The number of new cases went down so much that we hardly see one or two cases in a year.” Slash and burn Cultivator, FGD 01
“… if someone gets malaria and they do not go for treatment or receive treatment early, then they can die. If they take the medicine, this doesn`t become severe. …” Slash and burn cultivator, FGD 04
“… In that place, there are fewer bushes. As the whole place is cleaned by fire, it hardly remains as holt. The place becomes open to air. So, one cannot feel that many mosquitos…. Because mosquitos do not remain in an open-air area.” Slash and burn cultivator, FGD 03
Malaria preventive practices
“Everybody in the family sleeps under the bed net. Nobody is given special preference. If there are pregnant women or children in a family, then they are asked to sleep under the bed-nets more than anyone.” Slash and burn Cultivator, FGD 01
“Those of us who does Jhum work, we do not get extra bed nets for using at our workplace. So, we take the net that we have in our home with us, then bring it back with us again. Thus we use the bed nets.” Slash and burn Cultivator, FGD 04
“When extra people are staying at our house, or we do not have enough bed nets for everyone, we create “dhuma” (smoke). We also use mosquito coils.” Slash and burn Cultivator, FGD 02
“We seek BRAC’s help for malaria treatment. We have these ‘Didis’ (elder sister) who work in BRAC as health workers. They can give us treatment and medicine….. (therefore) we seek help from ‘didi’ who lives near our home. If they cannot help us, then we go to hospitals with their (community health workers from BRAC) referral, for testing and treatment. They have doctors there, who can do the rest of the treatment.” Slash and burn Cultivators, FGD 01
“Their service is excellent. At least it`s better than the service from the hospitals. You can contact them anytime, and you don`t have to spend any money for the services you get. If this is not good then what else.” Slash and burn Cultivator, FGD 04
Quantitative findings
Socio-demographic characteristics
Area name | Total N (%) | ||
---|---|---|---|
Kaptai n (%) | Sadar n (%) | ||
Gender | |||
Male | 79 (70.54) | 39 (44.32) | 118 (59.0) |
Female | 33 (29.46) | 49 (55.68) | 82 (41.0) |
Age (in years) | |||
18 to ≤ 39 | 42 (37.5) | 47 (53.4) | 89 (44.5) |
≥ 40 | 70 (62.5) | 41 (46.6) | 111 (55.5) |
Education level | |||
No schooling | 14 (12.50) | 28 (31.82) | 42 (21.00) |
Unfinished primary | 12 (10.71) | 18 (20.45) | 30 (15.00) |
Finished primary | 27 (24.11) | 18 (20.45) | 45 (22.50) |
Unfinished secondary | 24 (21.43) | 12 (13.64) | 36 (18.00) |
Finished secondary | 30 (26.79) | 8 (9.09) | 38 (19.00) |
Higher secondary and above | 5 (4.46) | 4 (4.55) | 9 (4.50) |
Own any cultivable land | |||
No | 59 (52.68) | 31 (35.23) | 90 (45.0) |
Yes | 53 (47.32) | 57 (64.77) | 110 (55.0) |
Poverty levela | |||
Poor | 58 (51.79) | 36 (40.91) | 94 (47.0) |
Non-poor | 54 (48.21) | 52 (59.09) | 106 (53.0) |
Knowledge about malaria
Area name | Total N (%) | ||
---|---|---|---|
Kaptai n (%) | Sadar n (%) | ||
Heard about malaria | |||
Yes | 95 (84.8) | 83 (94.3) | 178 (89.0) |
No | 17 (15.2) | 5 (5.7) | 22 (11.0) |
How is malaria transmitted | |||
By drinking contaminated water | 1 (0.9) | 1 (1.1) | 2 (1.0) |
By eating contaminated food | 3 (2.7) | 0 (0.0) | 3 (1.5) |
Mosquito bite | 94 (83.9) | 83 (94.3) | 177 (88.5) |
Close contact with an infected patient | 1 (0.9) | 1 (1.1) | 2 (1.0) |
Don’t know | 13 (11.6) | 3 (3.4) | 16 (8.0) |
Knows about basic signs (high fever and chills) | |||
Yes | 76 (67.9) | 49 (55.7) | 125 (62.5) |
No | 36 (32.1) | 39 (44.3) | 75 (37.5) |
When do malaria mosquito bites | |||
During night hours | 33 (29.5) | 58 (65.9) | 91 (45.5) |
Any time of the day | 55 (49.1) | 19 (21.6) | 74 (37.0) |
Don’t know | 24 (21.4) | 11 (12.5) | 35 (17.5) |
What are the treatment options available | |||
Allopathic treatment (modern medicine) | 90 (80.4) | 74 (84.1) | 164 (82.0) |
Self/homeopathic treatment | 22 (19.6) | 14 (15.9) | 36 (18.0) |
When to seek treatment | |||
Within 24 h | 87 (77.7) | 85 (96.6) | 172 (86.0) |
Beyond 24 h | 25 (22.3) | 3 (3.4) | 28 (14.0) |
Where to seek treatment | |||
Doctors with a professional degree | 48 (42.9) | 66 (75.0) | 114 (57.0) |
No or self-treatment/drug store/traditional healers | 64 (57.1) | 22 (25.0) | 86 (43.0) |
Main malaria preventive measures mentioneda | |||
Sleeping under a mosquito net | 81 (72.3) | 71 (80.7) | 125 (76.0) |
Clearing the environment from vegetation | 87 (77.7) | 40 (45.5) | 127 (63.5) |
Using ITNs | 72 (64.3) | 46 (52.3) | 118 (59.0) |
Attitudes toward malaria
Responses | ||||
---|---|---|---|---|
Strongly disagree n (%) | Disagree n (%) | Agree n (%) | Strongly agree n (%) | |
Anyone can be infected with malaria | 2 (1.0) | 32 (16.0) | 121 (60.5) | 45 (22.5) |
Only children and expectant women have the risk of contracting malaria | 5 (2.5) | 160 (80.0) | 34 (17.0) | 1 (0.5) |
Thinks malaria as a life-threatening disease | 3 (1.5) | 22 (11.0) | 133 (66.5) | 42 (21.0) |
During night time, sleeping under mosquito net can prevent malaria | 3 (1.5) | 29 (14.5) | 138 (69.0) | 30 (15.0) |
Working and sleeping overnight in the garden or forest can increase the threat of getting malaria | 3 (1.5) | 31 (15.5) | 154 (77.0) | 12 (6.0) |
It is dangerous not to take malaria medicine completely | 2 (1.0) | 22 (11.0) | 119 (59.5) | 57 (28.5) |
I feel like I should visit the health centers to get my blood tested if I suspect malaria | 1 (0.5) | 22 (11.0) | 147 (73.5) | 30 (15.0) |
Recovering from malaria without getting any treatment is possible | 38 (19.0) | 134 (67.0) | 23 (11.5) | 5 (2.5) |
Malaria prevention and treatment practice
Responses | |||
---|---|---|---|
Always n (%) | Sometimes n (%) | Never n (%) | |
How often do you sleep under a mosquito net? | 145 (72.5) | 52 (26.0) | 3 (1.5) |
How often do other members of the household sleep under mosquito nets? | 139 (69.5) | 54 (27.0) | 7 (3.5) |
How often do you check for holes/repair mosquito nets | 39 (19.5) | 134 (67.0) | 27 (13.5) |
How often do you use mosquito repellent coils on your house? | 15 (7.5) | 59 (29.5) | 126 (63.0) |
How often do you use the anti-mosquito spray in your house? | 4 (2.0) | 35 (17.5) | 161 (80.5) |
How often do you clean/cut bushes around your house? | 95 (47.5) | 86 (43.0) | 19 (9.5) |
How often do you clean stagnant water near your house? | 85 (42.5) | 103 (51.5) | 12 (6.0) |
How often do you visit the health center when you fall sick? | 17 (8.5) | 168 (84.0) | 15 (7.5) |
How often do you receive visits from the community health workers? | 71 (35.5) | 103 (51.5) | 26 (13.0) |