Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya

Abstract Background Assessing the acceptability of new malaria control interventions in clinical trials can be complex due to the need for strict ethical standards and specific trial procedures. While in-depth interviews and focus group discussions can provide useful insights, a more participatory m...

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Main Authors: Truphena Onyango, Khadija Nuru, Karisa Kazungu, Winnie Wangari, Carlos Chaccour, N. Regina Rabinovich, Joseph Mwangangi, Marta Maia, Caroline Jones
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Malaria Journal
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Online Access:https://doi.org/10.1186/s12936-025-05320-x
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author Truphena Onyango
Khadija Nuru
Karisa Kazungu
Winnie Wangari
Carlos Chaccour
N. Regina Rabinovich
Joseph Mwangangi
Marta Maia
Caroline Jones
author_facet Truphena Onyango
Khadija Nuru
Karisa Kazungu
Winnie Wangari
Carlos Chaccour
N. Regina Rabinovich
Joseph Mwangangi
Marta Maia
Caroline Jones
author_sort Truphena Onyango
collection DOAJ
description Abstract Background Assessing the acceptability of new malaria control interventions in clinical trials can be complex due to the need for strict ethical standards and specific trial procedures. While in-depth interviews and focus group discussions can provide useful insights, a more participatory method of data collection which complements these methods is photovoice. Photovoice offers a unique approach, empowering participants to share their experiences and perceptions on their own terms. Photovoice was employed alongside the BOHEMIA clinical trial (a trial investigating the safety and efficacy of ivermectin mass-drug administration (MDA) for malaria control) to explore participants' views on the trial and the effects of the intervention on individuals and communities. Methods Two participants from each of five villages involved in the trial (two intervention, three control) were purposively selected and trained on the ethical and technical use of cameras. During the final round of the intervention, participants photographed their trial experiences and the MDA effects. Two picture-sharing discussions were conducted to explore the picture content and reasons for their inclusion. Results Both intervention and control groups expressed confidence in the trial procedures, with pictures capturing barcode scanning and health assessments, activities reported to provide reassurance and enhance trust. Photos from both groups showed positive outcomes such as improved appetite and fewer mosquitoes. However, photos from the ivermectin group also showed clearing of jiggers and killing of bed bugs. Images of rashes, described as a negative effect of the MDA, were taken by both groups. Pictures of mosquito breeding sites and sources of intestinal worms were also shared by both groups. Conclusion Photovoice provided valuable insights into trial experiences, intervention effects, and revealed unexpected outcomes, such as killing of bedbugs, that warrant deeper exploration. It exposed broader community concerns of the source of malaria and intestinal worms not addressed by either the intervention or local health authorities.
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spelling doaj-art-32aa14c2de664dd5a9195eec8ea2d00a2025-08-20T03:01:42ZengBMCMalaria Journal1475-28752025-03-0124111810.1186/s12936-025-05320-xThrough the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, KenyaTruphena Onyango0Khadija Nuru1Karisa Kazungu2Winnie Wangari3Carlos Chaccour4N. Regina Rabinovich5Joseph Mwangangi6Marta Maia7Caroline Jones8Kenya Medical Research Institute, Centre for Geographic Medicine Research-CoastKenya Medical Research Institute, Centre for Geographic Medicine Research-CoastKenya Medical Research Institute, Centre for Geographic Medicine Research-CoastKenya Medical Research Institute, Centre for Geographic Medicine Research-CoastISGlobalISGlobalKenya Medical Research Institute, Centre for Geographic Medicine Research-CoastKenya Medical Research Institute, Centre for Geographic Medicine Research-CoastKenya Medical Research Institute, Centre for Geographic Medicine Research-CoastAbstract Background Assessing the acceptability of new malaria control interventions in clinical trials can be complex due to the need for strict ethical standards and specific trial procedures. While in-depth interviews and focus group discussions can provide useful insights, a more participatory method of data collection which complements these methods is photovoice. Photovoice offers a unique approach, empowering participants to share their experiences and perceptions on their own terms. Photovoice was employed alongside the BOHEMIA clinical trial (a trial investigating the safety and efficacy of ivermectin mass-drug administration (MDA) for malaria control) to explore participants' views on the trial and the effects of the intervention on individuals and communities. Methods Two participants from each of five villages involved in the trial (two intervention, three control) were purposively selected and trained on the ethical and technical use of cameras. During the final round of the intervention, participants photographed their trial experiences and the MDA effects. Two picture-sharing discussions were conducted to explore the picture content and reasons for their inclusion. Results Both intervention and control groups expressed confidence in the trial procedures, with pictures capturing barcode scanning and health assessments, activities reported to provide reassurance and enhance trust. Photos from both groups showed positive outcomes such as improved appetite and fewer mosquitoes. However, photos from the ivermectin group also showed clearing of jiggers and killing of bed bugs. Images of rashes, described as a negative effect of the MDA, were taken by both groups. Pictures of mosquito breeding sites and sources of intestinal worms were also shared by both groups. Conclusion Photovoice provided valuable insights into trial experiences, intervention effects, and revealed unexpected outcomes, such as killing of bedbugs, that warrant deeper exploration. It exposed broader community concerns of the source of malaria and intestinal worms not addressed by either the intervention or local health authorities.https://doi.org/10.1186/s12936-025-05320-xPhotovoiceMDARandomised control trialsIvermectinMalariaNTDs
spellingShingle Truphena Onyango
Khadija Nuru
Karisa Kazungu
Winnie Wangari
Carlos Chaccour
N. Regina Rabinovich
Joseph Mwangangi
Marta Maia
Caroline Jones
Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
Malaria Journal
Photovoice
MDA
Randomised control trials
Ivermectin
Malaria
NTDs
title Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
title_full Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
title_fullStr Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
title_full_unstemmed Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
title_short Through the eyes of the participant: using photovoice to understand the experiences and effects of ivermectin MDA in the context of the BOHEMIA clinical trial in Kwale, Kenya
title_sort through the eyes of the participant using photovoice to understand the experiences and effects of ivermectin mda in the context of the bohemia clinical trial in kwale kenya
topic Photovoice
MDA
Randomised control trials
Ivermectin
Malaria
NTDs
url https://doi.org/10.1186/s12936-025-05320-x
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