ArticleJournal of epidemiology and global health2025
"Have Scientists Done Enough?" Community Perspectives on Gene Drive-Modified Mosquitoes for Malaria Control in Northern Uganda: A Mixed-Methods Study.
Article in Journal of epidemiology and global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundGene-drive modified mosquitoes (GDMMs) offer a novel strategy for malaria control by genetically altering mosquito populations to reduce transmission. We assessed public awareness, attitudes, and factors influencing acceptance of GDMMs in Northern Uganda.
methodsThis mixed-methods study included both quantitative and qualitative components. In the quantitative survey, 301 participants were recruited through multistage stratified sampling. Data were collected using a structured questionnaire guided by the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB). Attitudes were measured using a 5-point Likert scale and categorized into favourable or unfavourable. A favourable attitude was defined as a positive disposition towards GDMMs; a high subjective norm score reflected strong perceived social support. Poisson regression was used to identify factors independently associated with acceptance, reported as adjusted prevalence ratios (aPRs), 95% confidence intervals and p-values. For the qualitative component, we conducted 22 in-depth interviews, which were analysed thematically using Atlas ti. 9.
resultsOf 301 participants, 169 (56.1%) were male, with a median age of 35 years (interquartile range [IQR]: 29-42). Only 60 (19.9%) were aware of GDMMs, mainly through social media (48.3%). Acceptance was reported by 193 participants (64.1% [95% CI: 58.4-69.5]). Overall, 129 (42.9%) participants had a favourable attitude, 102 (33.9%) had a high subjective norm score, and 101 (33.6%) had a high perceived behavioural control score. Independent predictors of GDMM acceptance included favourable attitude (aPR: 1.25, 95% CI: 1.05-1.49, p = 0.013), high subjective norm score (aPR: 1.28, 95% CI: 1.08-1.51, p = 0.004), and high perceived behavioural control (aPR: 1.23 [95% CI: 1.05-1.46, p = 0.013). Qualitative findings revealed three themes: limited awareness, facilitators (e.g., perceived benefits, trust in authorities, safety assurances), and barriers (e.g., environmental and ethical concerns).
conclusionsDespite low awareness, most participants supported GDMMs for malaria control. Acceptance was strongly influenced by attitudes, social norms, and behavioural control. Our findings underscore the relevance of HBM and TPB constructs particularly attitudes, social norms, and behavioural control in shaping public acceptance of emerging vector control technologies. Future implementation should integrate behavioural change models to address concerns, improve trust, and enhance adoption.
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