title: Intermittent preventive treatment of malaria in children: a qualitative study of community perceptions and recommendations in Burkina Faso and Mali.
abstract: BACKGROUND
  Intermittent preventive treatment of malaria in children (IPTc) is a highly efficacious method of malaria control where malaria transmission is highly seasonal. However, no studies published to date have examined community perceptions of IPTc.
  
  
  METHODS
  A qualitative study was undertaken in parallel with a double-blind, placebo-controlled, randomized trial of IPTc conducted in Mali and Burkina Faso in 2008-2009 to assess community perceptions of and recommendations for IPTc. Caregivers and community health workers (CHWs) were purposively sampled. Seventy-two in-depth individual interviews and 23 focus group discussions were conducted.
  
  
  RESULTS
  Widespread perceptions of health benefits for children led to enthusiasm for the trial and for IPTc specifically. Trust in and respect for those providing the tablets and a sense of obligation to the community to participate in sanctioned activities favoured initial adoption. IPTc fits in well with existing understandings of childhood illness. Participants did not express concerns about the specific drugs used for IPTc or about providing tablets to children without symptoms of malaria. There was no evidence that IPTc was perceived as a substitute for bed net usage, nor did it inhibit care seeking. Participants recommended that distribution be "closer to the population", but expressed concern over caregivers' ability to administer tablets at home.
  
  
  CONCLUSIONS
  The trial context mediated perceptions of IPTc. Nonetheless, the results indicate that community perceptions of IPTc in the settings studied were largely favourable and that the delivery strategy rather than the tablets themselves presented the main areas of concern for caregivers and CHWs. The study identifies a number of key questions to consider in planning an IPTc distribution strategy. Single-dose formulations could increase the success of IPTc implementation, as could integration of IPTc within a package of activities, such as bed net distribution and free curative care, for which demand is already high.
authors.affiliation: Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom. catherine.pitt@lshtm.ac.uk
authors.forename: Catherine
authors.initials: C
authors.lastname: Pitt
authors.forename: Halimatou
authors.initials: H
authors.lastname: Diawara
authors.forename: Dimlawendé J
authors.initials: DJ
authors.lastname: Ouédraogo
authors.forename: Samba
authors.initials: S
authors.lastname: Diarra
authors.forename: Habibou
authors.initials: H
authors.lastname: Kaboré
authors.forename: Kibsbila
authors.initials: K
authors.lastname: Kouéla
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Traoré
authors.forename: Alassane
authors.initials: A
authors.lastname: Dicko
authors.forename: Amadou T
authors.initials: AT
authors.lastname: Konaté
authors.forename: Daniel
authors.initials: D
authors.lastname: Chandramohan
authors.forename: Diadier A
authors.initials: DA
authors.lastname: Diallo
authors.forename: Brian
authors.initials: B
authors.lastname: Greenwood
authors.forename: Lesong
authors.initials: L
authors.lastname: Conteh
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use; D002050:Burkina Faso; D002675:Child, Preschool; D061345:Early Medical Intervention; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D008288:Malaria / Q000188:drug therapy / Q000517:prevention & control*; D008297:Male; D008302:Mali; D036301:Qualitative Research; D012111:Residence Characteristics
chemical_list: D000962:Antimalarials