Understanding perceptions of malaria control measures in Burundi: a qualitative descriptive study using a socio-ecological approach

BACKGROUND

In Burundi, malaria remains the leading cause of morbidity and mortality and persists as a major public health problem despite control strategies implemented nationally since 2000. While some quantitative studies have evaluated specific interventions, qualitative research examining the perceptions and practices of target populations regarding prevention measures is lacking. Such research is particularly important in the current context, where multiple control strategies are simultaneously implemented, potentially leading to confusion or reluctance among the population to adhere to prevention measures.

METHODS

A qualitative descriptive study was conducted from March to May 2023 in the health districts of Kinyinya and Ryansoro, combining 60 individual interviews and 28 focus group discussions (FGDs). The sample consisted primarily of farmers, with a slight female predominance (53% for individual interviews, 57.5% for FGDs). The collected data underwent thematic content analysis using a socio-ecological approach.

RESULTS

The study explored participants' perceptions and practices regarding four major interventions: distribution of long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), intermittent preventive treatment during pregnancy (IPTp-SP), and environmental management. The study identified factors influencing malaria prevention behaviours across three main interconnected levels: intrapersonal (perceived needs and adverse effects), organizational (information dissemination and hygiene conditions at healthcare facilities), and policy/environmental (need for context-sensitive adaptation of interventions and addressing socio-economic constraints).

CONCLUSION

Effective malaria prevention in Burundi requires a multifaceted approach addressing communication needs, contextual adaptation, management of adverse effects, understanding of local priorities, and socio-economic constraints. Integrating these five dimensions into programme design and adapting prevention messages accordingly would significantly improve both acceptance and effectiveness of malaria control interventions.