Knowledge, attitudes, and practices regarding malaria control among communities living in the south Cameroon forest region

What do women in the highest malaria burden country know about ways to prevent malaria? A multi-level analysis of the 2021 Nigeria Malaria Indicator Survey data

BACKGROUND

With Nigeria accounting for 31% of the estimated 608,000 deaths due to malaria globally, good knowledge of malaria prevention is essential for effective malaria control. The objective of this study was to examine the knowledge of malaria prevention and its associated factors among Nigerian women.

METHODS

This study analysed secondary data from the 2021 Nigeria Malaria Indicator Survey. The sample included 14,476 women of reproductive age (15-49 years). A multilevel multivariable logistic regression was used to examine individual, household, and community-level factors associated with having good knowledge of malaria prevention.

RESULTS

The weighted prevalence of having good knowledge of malaria prevention was 43.5% (95%CI: 41.7-45.2%). Women with secondary/higher education had 2.35 higher odds of good knowledge of malaria prevention, when compared with those with no formal/primary education (aOR = 2.35; 95% CI: 2.00-2.75). Those exposed to malaria messages had 2.62 higher odds of good knowledge of malaria prevention, when compared with no exposure to malaria messages (aOR = 2.62; 95% CI: 2.31-2.97). Women from non-poor households had 1.42 higher odds of good knowledge of malaria prevention, when compared with those from poor households (aOR = 1.42; 95% CI: 1.17-1.71). Rural dwellers had 39.0% reduction in the odds of good knowledge of malaria prevention, when compared with their urban counterparts (aOR = 0.61; 95% CI: 0.46-0.80). In addition, women from communities with high level of education (aOR = 2.24; 95%CI: 1.38-3.64), moderately exposed to malaria messages (aOR = 1.43; 95%CI: 1.08-1.88) and highly exposed to malaria messages (aOR = 1.71; 95%CI: 1.27-2.30), had higher odds of good knowledge of malaria prevention, when compared with women from communities with low education and low exposure to malaria messages, respectively.

CONCLUSION

The knowledge of malaria prevention was found to be low. The study identified education, religion, exposure to malaria messages, wealth, region, place of residence, community-level poverty, education and exposure to malaria messages as factors associated with the knowledge of malaria prevention. Addressing these factors through targeted interventions, such as improving educational opportunities for women and enhancing media-driven public health campaigns are essential to enhancing malaria knowledge among this critical demographic group.

Knowledge, attitudes and practices regarding malaria prevention and control in communities in the Eastern Region, Ghana, 2020

BACKGROUND

In sub-Saharan Africa countries including Ghana, the malaria burden remains unacceptably high and still a serious health challenge. Evaluating a community's level of knowledge, attitude, and practice (KAP) regarding malaria is essential to enabling appropriate preventive and control measures. This study aimed to evaluate knowledge of malaria, attitudes toward the disease, and adoption of control and prevention practices in some communities across the Eastern Region of Ghana.

METHODS

A cross‑sectional based study was carried out in 13 communities across 8 districts from January -June, 2020. Complete data on socio-demographic characteristics and KAP were obtained from 316 randomly selected household respondents by a structured pre-tested questionnaire. Associations between KAP scores and socio-demographic profiles were tested by Chi-square and binary logistic regression. Data analysis was done with SPSS version 26.0.

RESULTS

Most respondents (85.4%) had good knowledge score about malaria. Preferred choice of treatment seeking place (50.6%) was the health center/clinic. All respondents indicated they would seek treatment within 24 hours. Mosquito coils were the preferred choice (58.9%) against mosquito bites. Majority of households (58.5%) had no bed nets and bed net usage was poor (10.1%). Nearly half of the respondents (49.4%) had a positive attitude toward malaria and 40.5% showed good practices. Chi-square analysis showed significant associations for gender and attitude scores (p = 0.033), and educational status and practice scores (p = 0.023). Binary logistic regression analysis showed that 51-60 year-olds were less likely to have good knowledge (OR = 0.20, p = 0.04) than 15-20 year-olds. Respondents with complete basic schooling were less likely to have good knowledge (OR = 0.33, p = 0.04) than those with no formal schooling. A positive attitude was less likely in men (OR = 0.61, p = 0.04). Good malaria prevention practice was lower (OR = 0.30, p = 0.01) in participants with incomplete basic school education compared to those with no formal schooling.

CONCLUSION

Overall scores for respondents' knowledge, though good, was not reflected in attitudes and levels of practice regarding malaria control and prevention. Behavioral change communication, preferably on radio, should be aimed at attitudes and practice toward the disease.

Knowledge, attitude, and adherence to malaria control guidelines and the prevalence of Plasmodium species infection in localities across transmission and ecological zones in Cameroon

Background

Despite a scale up of control interventions over the years, malaria remains a major public health and economic concern in Cameroon, contributing considerably to hospitalization and deaths. The effectiveness of control strategies depends on the extent of adherence by the population to national guidelines. This study assessed the influence of human knowledge, attitudes, and practices related to malaria and its control on the prevalence of malaria parasite infection, with implications for the elimination of the disease.

Methodology

This is a cross-sectional community and hospital-based study, covering the five ecological and three malaria transmission zones in Cameroon. A pre-tested semi-structured questionnaire was used to document socio-demographic and clinical parameters as well as knowledge, attitudes, and practices toward malaria control and management. Consenting participants were screened for malaria parasite with rapid diagnostic test (mRDT) of the peripheral blood. Association between qualitative variables was determined using the chi-square test and logistic regression analysis.

Results

A total of 3,360 participants were enrolled, 45.0% (1,513) of whom were mRDT positive, with 14.0% (451/3,216) and 29.6% (951/3,216) having asymptomatic parasitaemia and malaria, respectively. Although most participants knew the cause, symptoms, and control strategies, with 53.6% (1,000/1,867) expertly knowledgeable about malaria overall, only 0.1% (2/1,763) individuals were fully adherent to malaria control measures.

Conclusion

The risk of malaria in Cameroon remains high, with the population considerably knowledgeable about the disease but poorly adherent to national malaria control guidelines. Concerted and more effective strategies aimed at improving knowledge about malaria and adherences to control interventions are necessary to ultimately eliminate the disease.