Community Acceptance of Tsetse Control Baits: A Qualitative Study in Arua District, North West Uganda

BackgroundThere is renewed vigour in efforts to eliminate neglected tropical diseases including sleeping sickness (human African trypanosomiasis or HAT), including attempts to develop more cost-effective methods of tsetse control. In the West Nile region of Uganda, newly designed insecticide-treated targets are being deployed over an area of ∼500 km2. The operational area covers villages where tsetse control has not been conducted previously. The effectiveness of the targets will depend, in part, on their acceptance by the local community.Methodology/Principal FindingsWe assessed knowledge, perceptions and acceptance of tsetse baits (traps, targets) in villages where they had or had not been used previously. We conducted sixteen focus group discussions with male and female participants in eight villages across Arua District. Discussions were audio recorded, translated and transcribed. We used thematic analysis to compare the views of both groups and identify salient themes.Conclusions/SignificanceDespite the villages being less than 10 km apart, community members perceived deployed baits very differently. Villagers who had never seen traps before expressed fear, anxiety and panic when they first encountered them. This was related to associations with witchcraft and “ghosts from the river” which are traditionally linked with physical or mental illness, death and misfortune. By contrast, villagers living in areas where traps had been used previously had positive attitudes towards them and were fully aware of their purpose and benefits. The latter group reported that they had similar negative perceptions when tsetse control interventions first started a decade ago. Our results suggest that despite their proximity, acceptance of traps varies markedly between villages and this is related to the duration of experience with tsetse control programs. The success of community-based interventions against tsetse will therefore depend on early engagements with communities and carefully designed sensitization campaigns that reach all communities, especially those living in areas new to such interventions.研究背景：当前，针对包括昏睡病（人类非洲锥虫病，human African trypanosomiasis，缩写HAT）在内的被忽视热带病的消除工作再度焕发活力，其中包括开发更具成本效益的采采蝇（tsetse）防控手段的尝试。在乌干达西尼罗河地区，新型经杀虫剂处理的采采蝇诱捕靶标正被部署在约500平方千米的区域内。该作业区域覆盖此前从未开展过采采蝇防控工作的村落。此类靶标的防控效果在一定程度上取决于当地社区的接受度。 研究方法与主要结果：我们针对此前部署过或未部署过采采蝇诱饵（诱捕器、靶标）的村落，评估了当地居民对采采蝇诱饵的认知水平、态度倾向与接受程度。我们在阿鲁阿区的8个村落开展了16场焦点小组讨论（focus group discussions），参与者涵盖男性与女性村民。所有讨论内容均进行了录音、翻译与转录，并采用主题分析法（thematic analysis）对两组参与者的观点进行对比，识别出核心主题。 研究结论与意义：尽管这些村落之间的直线距离不足10千米，但社区居民对部署的采采蝇诱饵的认知却存在极大差异。此前从未见过诱捕器的村民在首次接触这类装置时，表现出恐惧、焦虑与恐慌情绪。这种情绪与当地传统认知中与巫术、“河中鬼魂”相关的联想有关——这类意象通常被认为与躯体或精神疾病、死亡及不幸存在关联。与之形成鲜明对比的是，此前所在区域已使用过诱捕器的村民则对其持有积极态度，且完全清楚其用途与益处。后一类村民表示，十年前采采蝇防控干预措施首次启动时，他们也曾抱有类似的负面认知。我们的研究结果表明，尽管村落地理位置相近，但不同村落对诱捕器的接受度差异显著，且这种差异与当地参与采采蝇防控项目的时长密切相关。因此，基于社区的采采蝇防控干预措施能否取得成功，将取决于与社区的早期沟通对接，以及精心设计的宣传科普活动——此类活动需覆盖所有社区，尤其是此前从未接触过此类干预措施的区域。