COMMUNITY REACTIONS TO THE INTRODUCTION OF PERMETHRIN-TREATED BED NETS FOR MALARIA CONTROL DURING A RANDOMIZED CONTROLLED TRIAL IN WESTERN KENYA

JANE A. ALAII Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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H. W. VAN DEN BORNE Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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S. PATRICK KACHUR Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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KAREN SHELLEY Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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HALIMA MWENESI Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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JOHN M. VULULE Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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WILLIAM A. HAWLEY Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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BERNARD L. NAHLEN Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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PENELOPE A. PHILLIPS-HOWARD Center for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences; Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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Prior to implementation of a randomized controlled trial of insecticide (permethrin)-treated bed nets (ITNs) in western Kenya, ethnographic studies were conducted to understand local perceptions of disease, sleeping patterns, and other factors that might affect use of ITNs. Educational activities took place prior to distribution, but immediately after distribution in Asembo only approximately half of the ITNs were in use. A qualitative study was then conducted to identify the community’s perceptions about ITNs and the ITN project. While participants ranked malaria as important and recognized that malaria prevention could be beneficial, they believed ITNs would be only partly effective due to the perception that malaria has multiple causes. Concerns expressed included fear of the insecticide, thought by some to be a toxic family planning aid, the taking of blood during clinical studies, and the mixing up of family ITNs during net re-treatment, which would violate cultural taboos. Attempts were made to allay fears by improved communication on these subjects and modification of the study design.

Author Notes

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