title: Determining the impact of community awareness-raising activities on the prevention of malaria transmission in Palawan, the Philippines.
abstract: Palawan has the highest malaria endemicity in the Philippines, and malaria remains a major health burden in the region. In 1999, 344 microscopists were trained in Palawan. This allowed for early diagnosis and prompt treatment throughout the island. To take a significant step toward the elimination of malaria on the island, microscopists implemented community awareness-raising activities aimed at preventing transmission of malaria. The objective of the present study was to determine the impact of these activities on the self-implemented preventive measures against malaria by the ex-patients of the microscopists. Structured interviews were carried out from January to February in 2012, in 20 remote malaria-endemic villages throughout Palawan. In total, 141 ex-patients who had previously been diagnosed malaria-positive by the microscopists, volunteered to participate in the present study. Structural equation modeling was conducted to determine factors associated with self-implemented preventive measures against malaria, which included: (1) place of residence; (2) socio-demographic characteristics; (3) knowledge on malaria; (4) participation in community awareness-raising activities for malaria prevention; and (5) satisfaction with microscopists. Structural equation modeling identified six significant factors independently associated with self-implemented preventive measures against malaria; ethnicity, knowledge on malaria transmission, knowledge on vector species, knowledge on vector's most active time, participation in awareness-raising activities for malaria prevention by microscopists, and satisfaction with microscopists. Tagalog ethnicity (the predominant ethnic group) was positively related to better self-implemented preventive measures. In conclusion, aside from providing early diagnosis and treatment, microscopists played a significant role in self-implemented preventive measures against malaria. The strengthening of awareness-raising activities by microscopists was suggested to be an effective strategy for reducing malaria re-infection in Palawan. These activities should be strengthened to improve preventive measures implemented by ex-patients traveling to mountain areas and to enhance the knowledge on malaria transmission particularly among indigenous residents.
authors: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan; Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. Electronic address: emilie@m.u-tokyo.ac.jp.
authors: Emilie Louise Akiko
authors: EL
authors: Matsumoto-Takahashi
authors: Department of Parasitology, College of Public Health, University of the Philippines Manila, 625 Pedro Gil Street, Ermita, Manila, the Philippines. Electronic address: ptongolrivera@yahoo.com.
authors: Pilarita
authors: P
authors: Tongol-Rivera
authors: Department of Parasitology, College of Public Health, University of the Philippines Manila, 625 Pedro Gil Street, Ermita, Manila, the Philippines. Electronic address: eavillacorte@yahoo.com.
authors: Elena A
authors: EA
authors: Villacorte
authors: Kilusan Ligtas Malaria/Pilipinas Shell Foundation, Inc., SPS Government Center, Bancao Bancao, Puerto Princessa City, Palawan 5300, the Philippines. Electronic address: rayangluben@yahoo.com.
authors: Ray U
authors: RU
authors: Angluben
authors: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan. Electronic address: jyasuoka@post.harvard.edu.
authors: Junko
authors: J
authors: Yasuoka
authors: Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. Electronic address: kano@ri.ncgm.go.jp.
authors: Shigeyuki
authors: S
authors: Kano
authors: Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8654, Japan. Electronic address: mjimba@m.u-tokyo.ac.jp.
authors: Masamine
authors: M
authors: Jimba
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000592:standards / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010679:Philippines / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Community health workers; Malaria; Microscopist; Patients; Prevention; The Philippines