Use Of Eucalyptus Oil In Mobile And Migrant Populations As A Positive Deviance To Prevent Malaria On Buru Island, Indonesia: An Efforts To Accelerate And Maintain Malaria Elimination In Specific Populations

Abstract

Malaria is still a public health problem worldwide, which is increasingly difficult to handle due to the Covid-19 pandemic. Indonesia is a country targeted by WHO to become a Malaria-free country by 2030. Mobile and migrant populations (MMPs) on Buru Island, as a Malaria-vulnerable group, pose a particular challenge in efforts to accelerate and maintain elimination. The use of eucalyptus oil as a positive deviation (PD) in this group is an innovative strategy in Malaria control programs in this population.

Methods: This research is an analytic observational study with a cross-sectional design to see the relationship between PD and Malaria in MMPs. Multivariate analysis with logistic regression was performed to determine the most associated PD  with Malaria in the MMPs group. Primary data was collected through interviews with a structured questionnaire and observation of 72 people from the MMPs group who met the criteria.

Results and Discussion: From 19 PD identified, only seven related to Malaria in MMPs (p-value <α 0.05) in preventing Malaria: cleaning the environment (p=0.032), burning garbage (p=0.005), burning dry leaves ( p=0.013), using the eucalyptus oil (0.001), consuming herbal medicine (p=0.013), "Baupu"/" Baukuf" (p=0.028) and utilizing hot steam from a "Kettle" (p=0.043). The logistic regression analysis showed that eucalyptus oil was the variable most related to Malaria prevention in MMPs (p=0.027;95% CI for EXP(B): 1.227 – 30.799).

Conclusions and suggestions: Identification of PD and applying them in everyday life is essential in preventing Malaria in MMPs. Utilizing the potential of eucalyptus oil as a natural way to prevent Malaria in the era of elimination is an innovative and promising specific local-based approach, considering that Buru Island is a eucalyptus granary area in Maluku, Indonesia.