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

Background
There 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 Findings
We 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/Significance
Despite 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（human African trypanosomiasis，简称HAT）在内的被忽视的热带病的防控工作再度焕发活力，其中涵盖研发更为经济高效的采采蝇（tsetse）防控手段。在乌干达西尼罗河区域，研究团队正在约500平方公里的范围内部署新型经杀虫剂处理的诱捕靶标（insecticide-treated targets）。本次作业区域覆盖了此前从未开展过采采蝇防控工作的村庄，而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程度。

材料与方法/主要研究结果
本研究针对此前布设过或未布设过采采蝇诱饵（诱捕器、诱捕靶标）的村庄，评估了当地居民对采采蝇诱饵的认知、看法与接受度。我们在阿鲁阿区的8个村庄开展了16场焦点小组讨论（focus group discussions），参与者涵盖男女村民。讨论过程均进行了录音、转译与誊录，随后采用主题分析法（thematic analysis）对比两组参与者的观点，识别核心主题。

结论与意义
尽管这些村庄间距不足10公里，但社区居民对所部署的采采蝇诱饵的认知却存在显著差异。此前从未接触过诱捕器的村民在首次见到这类装置时，表现出恐惧、焦虑与恐慌情绪，这与他们将装置与巫术以及“河中幽灵”相关联有关——这类传统意象在当地认知中与躯体或精神疾病、死亡及厄运紧密绑定。与之形成鲜明对比的是，此前生活在布设过诱捕器区域的村民对这类装置持有积极态度，且充分知晓其用途与益处。该群体表示，在十年前首次启动采采蝇防控干预时，他们也曾抱有类似的负面认知。本研究结果表明，尽管村庄间距极近，但不同村落对诱捕装置的接受度差异显著，这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若要取得成功，需提前与社区开展充分沟通，并精心设计覆盖所有社区的宣传动员活动，尤其要覆盖那些此前未接触过此类干预措施的社区。