Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 26;19(23):15764.
doi: 10.3390/ijerph192315764.

Generating Trust in Participatory Research on Plasmodium knowlesi Malaria: A Study with Rural Community Gatekeepers during the COVID-19 Pandemic

Nurul Athirah Naserrudin  1   2   3 , Richard Culleton  4 , Pauline Yong Pau Lin  5 , Sara Elizabeth Baumann  6 , Rozita Hod  1 , Mohammad Saffree Jeffree  2   7 , Kamruddin Ahmed  2   7   8 , Mohd Rohaizat Hassan  1   2
Affiliations

Generating Trust in Participatory Research on Plasmodium knowlesi Malaria: A Study with Rural Community Gatekeepers during the COVID-19 Pandemic

Nurul Athirah Naserrudin et al. Int J Environ Res Public Health. .

Abstract

Background: Plasmodium knowlesi malaria is a zoonotic infection that affects rural communities in South East Asia. Although the epidemiology of the disease has been extensively researched, the voices of individuals within affected communities often go unheard. Here, we describe a study that explores the importance of gatekeepers in conducting research among rural communities, their perspectives on the challenges encountered when attempting to avoid malaria infection, and their views on participatory research.

Methods: Between 1 November 2021 and 28 February 2022, we conducted a study in Kudat district, Sabah, using a multi-method design. All participants consented to the study, which included health care workers (HCWs) (n = 5), community leaders (n = 8), and faith leaders (n = 1). We conducted interviews, transect walks, and observations with gatekeepers to ensure data trustworthiness. All interviews were conducted in the Sabah Malay dialect. The sessions were audio- and video-recorded, transcribed into English and analyzed using thematic analysis.

Results: Between 2017 and 2021, the number of cases of P. knowlesi malaria detected in humans ranged from 35 to 87 in villages under the care of the Lotong primary health care clinic. The challenges in controlling malaria include social norms, lifestyles, socioeconomic factors, environmental factors, and limitations of basic resources. Critical discussions regarding participation with the gatekeepers identified that face-to-face interviews were preferable to online discussions, and influenced willingness to participate in future research.

Conclusion: This study was conducted among village gatekeepers during the COVID-19 pandemic and generated information to drive methodological changes, opening up new ideas by sharing perspectives on challenges in P. knowlesi malaria control among vulnerable communities. The study generated trust in the community and expanded knowledge regarding participation that is critical for future community-based studies.

Keywords: Plasmodium knowlesi; challenges control; exploratory study; field study; gatekeepers; interview; malaria prevention; observation; participatory research.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Entry route to the study area.
Figure 2
Figure 2
Flowchart of the systematic steps completed during the study, goals, and products.
Figure 3
Figure 3
“No entry to outsiders” sign in the Malay language outside the village.
Figure 4
Figure 4
Map of the Kudat district.
Figure 5
Figure 5
The study sites.
Figure 6
Figure 6
Challenges to avoid malaria infection based on the perspective of gatekeepers.
Figure 7
Figure 7
Commercial oil palm plantation (left), with coconut and banana trees at the village.
Figure 8
Figure 8
A local villager’s house surrounded by forest, plantation and fruit trees.
Figure 9
Figure 9
The “sulap”.
See this image and copyright information in PMC

References

    1. Davidson G., Chua T.H., Cook A., Speldewinde P., Weinstein P. Defining the ecological and evolutionary drivers of Plasmodium knowlesi transmission within a multi-scale framework. Malar. J. 2019;18:1–13. doi: 10.1186/s12936-019-2693-2. - DOI - PMC - PubMed
    1. World Health Organization (WHO) WHO; Geneva, Switzerland: 2021. Malaria Policy Advisory Group (MPAG) Meeting.
    1. Grigg M.J., Cox J., William T., Jelip J., Fornace K.M., Brock P.M., von Seidlein L., Barber B.E., Anstey N.M., Yeo T.W., et al. Individual-level factors associated with the risk of acquiring human Plasmodium knowlesi malaria in Malaysia: A case-control study. Lancet Planet. Health. 2017;1:e97–e104. doi: 10.1016/S2542-5196(17)30031-1. - DOI - PMC - PubMed
    1. Herdiana H., Cotter C., Coutrier F.N., Zarlinda I., Zelman B.W., Tirta Y.K., Greenhouse B., Gosling R.D., Baker P., Whittaker M., et al. Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum. Malar. J. 2016;15:1–15. doi: 10.1186/s12936-016-1523-z. - DOI - PMC - PubMed
    1. Brown R., Chua T.H., Fornace K., Drakeley C., Vythilingam I., Ferguson H.M. Human exposure to zoonotic malaria vectors in village, farm and forest habitats in Sabah, Malaysian Borneo. PLOS Negl. Trop. Dis. 2020;14:e0008617. doi: 10.1371/journal.pntd.0008617. - DOI - PMC - PubMed

Publication types