Effective Behavior Change Communications to Prevent Malaria Morbidity and Mortality in Global Workforces

To prevent serious malaria morbidity and deaths in business travelers and workers in malaria-endemic regions, we used behavior change communication tools to promote the A-B-C-D's of malaria prevention: Awareness, Bite Prevention, Chemoprophylaxis, Detection and early treatment. High levels of compliance with malaria chemoprophylaxis confirmed with random testing and extremely low numbers of malaria cases confirmed the effectiveness of our communication methods. Employees must complete an interactive computer-based training program utilizing provocative videos to acquire overall Awareness and to learn the skills needed for effective vector control and Bite prevention. Before traveling, employees visit travel health clinics to receive bite-prevention supplies and chemoprophylaxis (for non-immunes) along with colorful literature to remind them of the A-B-C-D's. In-country arrival processes include the use of a questionnaire for travelers to demonstrate their knowledge of malaria prevention, and random checks verify their readiness with respect to bite prevention. Different educational messages target individuals considered non-immune or semi-immune to malaria to address attitudes and social norms regarding Chemoprophylaxis use. Posters, DVDs, and presentations promote malaria prevention in safety meetings and safety reminders communicated at the beginning of work shifts continually reinforce malaria prevention efforts. Pre-departure audio and video tapes are used while transporting travelers back to the airports to encourage their continued use of prescribed medications and to remind them to use their malaria survival kits for Diagnosis and treatment should symptoms arise. Annual World Malaria Day activities that engage community participants also emphasize the importance of malaria control programs.