ABSTRACT.
malaria, soil-transmitted
MALARIA, SCHISTOSOMIASIS, HELMINTHIASIS, DISEASE, DISEASES
Financial support: This study was implemented as part of a career development fellowship awarded to M. O. A., funded under the United Kingdom Research and Innovation Future Leaders Fellowship scheme (MR/S03286X/1). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ethics approvals for the study were obtained from the Research Ethics Committees of the London School of Hygiene & Tropical Medicine (Reference number 26770) and the Comité National d’Ethique pour la Recherche en Santé, Senegal (reference no. 0000111/MSAS/CNERS/SP). The informed consent document was translated into French by a certified translator who had experience in clinical research. Trained field assistants who were native speakers obtained verbal informed consent from study participants aged 18 years and older, by interpreting the consent information in a Senegalese language (Wolof, Fula, or Malinké) or French, as preferred by the participants. In line with the ethical guidance in Senegal, assent was obtained from a child participant aged 12 to 14 years, in addition to a parental consent, after a trained research assistant had explained the consent information to the child in a comprehensible manner. Participation in the study was voluntary, and confidentiality was maintained by anonymization and storage of participant data in encrypted computers.Authors’ addresses: Muhammed O. Afolabi and Brian Greenwood, Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom, E-mails: Integration of vertical programs for the control of malaria, schistosomiasis, and soil-transmitted helminthiasis has been recommended to achieve elimination of malaria and neglected tropical diseases (NTD) by 2030. This qualitative study was conducted within the context of a randomized controlled trial to explore the perceptions and views of parents/caregivers of at-risk children and healthcare providers to determine their acceptability of the integrated malaria-helminth treatment approach. Randomly selected parents/caregivers of children enrolled in the trial, healthcare providers, trial staff, malaria, and NTD program managers were interviewed using purpose-designed topic guides. Transcripts obtained from the interviews were coded and common themes identified using content analysis were triangulated. Fifty-seven study participants comprising 26 parents/caregivers, 10 study children aged ≥ 10 years, 15 trial staff, four healthcare providers, and two managers from the Senegal Ministry of Health were interviewed. Thirty-eight of the participants (66.7%) were males, and their ages ranged from 10 to 65 years. Overall, the integrated malaria–helminth treatment approach was considered acceptable, but the study participants expressed concerns about the taste, smell, and side effects associated with amodiaquine and praziquantel in the combination package. Reluctance to accept the medications was also observed among children aged 10 to 14 years due to peer influence and gender-sensitive cultural beliefs. Addressing concerns about the taste and smell of amodiaquine and praziquantel is needed to optimize the uptake of the integrated treatment program. Also, culturally appropriate strategies need to be put in place to cater for the inclusion of children aged 10 to 14 years in this approach.