Health Education by Buddhist Monks to Promote Malaria Knowledge and Preventive Practices in Rural Myanmar

Monastery-based Health Education by Buddhist Monks to Promote Malaria Knowledge and Preventive Practices in Rural Myanmar: A Quasi-experimental Study

Malaria is still a leading public health concern in Myanmar. However, people living in rural areas usually showed poor prevention practice despite residing in malaria hotspots. The majority in Myanmar are Buddhists who frequently visit the monastery and receive the speech delivered by the monks. In a malaria high burden township of the Sagaing Region from northern Myanmar, current study will first explore the difference in malaria preventive practices among people residing in different malaria-endemic villages through a mixed-methods approach. Next, this research will address the knowledge gaps by a monastery-based health education delivered by trained Buddhist monks using standardized health messages instruction for six consecutive months between August 2022 to January 2023. To test whether the intervention could balance those gaps among different groups, quantitative data of baseline, 3-month, and 6-month will be compared using descriptive statistics, chi-square test, T-test or repeated ANOVA, and the Difference-In-Differences (DID) analysis, as applicable.

Study Overview

• Status: Completed
• Conditions: Malaria; Health Education; Buddhist Monks; Monastery-based; Myanmar; Preventive Practice
• Intervention / Treatment: Behavioral: Monastery-based health education by Buddhist monks

• Study Type: Interventional
• Enrollment (Actual): 501
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Myanmar
  • Yangon, Myanmar, 11091
    • Myanmar Health Network Organization

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

For educational intervention; - voluntary participation

For questionnaire surveys;

• male or female household leaders or immediate family members
• aged >18 years who had resided in the study villages for more than one year

Exclusion Criteria:

For questionnaire surveys;

- Individuals who were unable to communicate effectively or were under the influence of narcotics, including alcohol

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; Participants in the control group just received routine malaria control services such as diagnostic, treatment and bed net distribution.
Experimental: Monastery-based health education intervention; The education sessions were conducted in Burmese by trained monks. They followed the normal teachings of the Buddhist doctrine and typically lasted 30-40 minutes. Our research utilized Burmese as the medium for delivering health messages, and all accompanying materials were meticulously prepared in Burmese. The study team observed at least one to two education sessions in each study village.	Behavioral: Monastery-based health education by Buddhist monks; During the three-month intervention from July to September 2022, a total of 18 health education sessions were conducted across the three intervention villages, with an average of 50 attendees per session, totaling 921 attendees across all sessions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Malaria knowledge and preventive practices	To assess pre-existing malaria knowledge and preventive practices among both intervention and control groups, pre-intervention surveys were conducted. Subsequently, three- and six-month post-intervention surveys were conducted to evaluate changes following the intervention. A validated questionnaire translated from English to Burmese was used. The questionnaire comprised three sections: demographic information of the respondents, knowledge of malaria and preventive practices. Each section had multiple small questions, and each correct answer was scored. The resultant scores were aggregated, wherein every participant had the potential to accrue a maximum of ten points pertaining to the attribution of malaria causation, symptoms of malaria, and adoption of personal preventative measures against malaria. The participants were eligible to secure eight points in the domain of malaria diagnosis and treatment, alongside twelve scores for the use of LLINs.	Pre intervention (July 2022), 3-month post-intervention (Dec 2022) and 6-month post-intervention (Mar 2023)

Collaborators and Investigators

• Sponsor: Myanmar Health Network Organization
• Collaborators: Chulalongkorn University; Ministry of Health and Sports, Myanmar

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2022
• Primary Completion (Actual): March 31, 2023
• Study Completion (Actual): March 30, 2024

Study Registration Dates

• First Submitted: April 23, 2024
• First Submitted That Met QC Criteria: April 23, 2024
• First Posted (Actual): April 26, 2024

Study Record Updates

• Last Update Posted (Actual): April 29, 2024
• Last Update Submitted That Met QC Criteria: April 25, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Infections; Vector Borne Diseases; Parasitic Diseases; Protozoan Infections; Mosquito-Borne Diseases; Malaria
• Other Study ID Numbers: MHNO-001

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No