Exploring community perspectives and experiences of larviciding for malaria control in Papua New Guinea

Background A resurgence of malaria in Papua New Guinea (PNG) has prompted exploration of additional vector control tools that can complement insecticide treated nets, including larviciding, a type of larval source management. Understanding determinants of community acceptability of additional approaches such as larviciding is vital to inform future implementation strategies. This study aims to understand community-level perceptions, enablers and barriers related to larvicide use in water bodies in a rural village in Madang province, PNG. Methods Four focus group discussions (FGDs) and eleven semi-structured interviews (SSIs) were conducted with community members in a rural village along the south coast of Madang Province, PNG. FGDs were conducted with a combination of participants who did and did not have their water bodies treated with larvicides. Qualitative data analysis software NVivo 14 was used to thematically code transcripts inductively, using a coding framework to identify themes and sub-themes as they emerged. Results Enablers to acceptability included attendance at awareness sessions and knowledge that larviciding is safe for humans and the environment, building positive relationships and trusted partnerships with local community leaders and stakeholders, and recognising the importance of traditional approaches to malaria prevention and care. Barriers to acceptability included fears of unknown side effects and toxicity of larviciding to humans, animals and ecosystems, perception that larviciding is unnecessary and ineffective, and poor attendance at larviciding awareness sessions. Participants expressed willingness to purchase larvicides for between 5–50 PGK, preferably from trusted sources such as health clinics or government groups who can provide accurate information on how to apply them safely. Conclusions Using a community-based approach to engage, educate and address community concerns surrounding larviciding should be prioritised. Culturally tailored implementation strategies that respect and incorporate local knowledge and emphasise the safety to humans, animals and ecosystems are more likely to foster acceptability.