Knowledge, attitude and practice levels regarding malaria among people living in the malaria endemic area of Myanmar

Knowledge, compliance, and challenges in anti-malarial products usage: a systematic review of at-risk communities for zoonotic malaria

BACKGROUND

Zoonotic malaria is a growing public health threat in the WHO Southeast Asia (SEA) and Western Pacific (WP) regions. Despite vector-control measures, the distribution of Macaque fascicularis and M. nemestrina, and Anopheles mosquitoes carrying non-human simian malaria parasites poses challenges to malaria elimination. The systematic review assesses the literature on knowledge and malaria-preventive practices in zoonotic malaria-affected areas across the WHO SEA and WP, aiming to identify challenges for malaria control.

METHODS

Peer-reviewed articles published in English, Malay and Indonesian between January 2010 and December 2022 were searched in OVID Medline, Scopus, Web of Science, and Google Scholar. Studies of any design-excluding reviews, conference proceedings, and reports from all WHO SEA and WP countries vulnerable to zoonotic malaria-were included. Backwards-reference screening and thematic analysis were conducted.

RESULTS

Among 4,174 initially searched articles, 22 peer-reviewed articles met the inclusion criteria. An additional seven articles were identified through backwards-reference screening, resulting in a total of 29 articles for this review. Half of these studies were conducted in Cambodia, Myanmar, Malaysia, and Thailand, mainly in forests and remote communities. The review highlighted inconsistencies in the operationalization of knowledge, and five major themes were identified related to knowledge: causation and transmission, symptoms, treatment, severity and complications, and malaria prevention. While participants generally had some understanding of malaria causation/transmission, minority and indigenous ethnic groups demonstrated limited knowledge and held misconceptions, such as attributing malaria to drinking dirty water. Preventive practices included traditional and non-traditional or modern methods-with a preference for traditional approaches to avoid mosquito bites. Challenges to malaria control included feasibility, cost, and access to healthcare services.

CONCLUSION

This review provides insights into knowledge, local understandings, and preventive practices related to malaria in the WHO SEA and WP regions. The findings highlight the need for future research to explore the knowledge of at-risk communities regarding zoonotic malaria, their perceive threat of the disease and factors exposing them to zoonotic malaria. New strategies must be developed for zoonotic malaria programs tailored to local contexts, emphasizing the significance of community participation, health education, and socio-behavioural change initiatives. It is important to consider the interconnectedness of human health, environmental and non-human primates conservation. Socio-cultural nuances should also be carefully considered in the design and implementation of these programs to ensure their effect tailored to local contexts.

Assessment of malaria prevention knowledge, attitude, and practice and associated factors among households living in rural malaria-endemic areas in the Afar Pastoral Region of Ethiopia

Background

Malaria morbidity has reduced significantly in most regions of Ethiopia, but it is still a serious issue in the northeast, particularly in the Afar region.

Objective

The study aimed to evaluate household heads' knowledge, attitudes, and practices toward malaria prevention and its associated factors in rural Ada'ar woreda district in the Afar region.

Methods

A community-based cross-sectional study was conducted among 422 households living in Ada'ar woreda district. A systematic sampling technique was used to select households. A pre-tested, structured questionnaire was used to interview randomly selected adult household heads. Frequency and percentage were computed. Logistic regression was used to determine the association between independent and dependent variables. Statistical significance was considered to be a p-value <0.05.

Results

Nearly two-thirds (64.2%) of household heads had good knowledge of malaria prevention, and 46.9% had a positive attitude toward it. About 17.3 and 56.9% of study participants had good malaria prevention practices and good healthcare seeking behaviors, respectively. Illiterate (AOR = 2.62, 95% CI: 1.49-4.63) and low-income (AOR = 2.6, 95% CI: 1.2-5.6) participants were more likely to have poor knowledge of malaria prevention (malaria signs and symptoms, malaria transmissions, and malaria prevention methods). Married participants (AOR = 2.52, 95% CI: 1.02-6.29) and illiterates (AOR = 2.83, 95% CI: 1.69-4.73) had negative attitudes toward malaria prevention. Household heads with poor knowledge of malaria prevention had 85% higher rates of practicing poor malaria prevention methods (regular bed nets used; AOR = 1.85, 95% CI: 1.2-2.8). Young adults (18-25 years) were more likely to have poor healthcare seeking behaviors (AOR = 3.5, 95% CI: 1.73-7.1), while pastoralists had a lower likelihood (AOR = 0.46, 95% CI: 0.28-0.8).

Conclusion

Knowledge, attitude, and practices toward malaria prevention remain a problem in malaria-endemic rural areas of the Afar region of Ethiopia. There is a need for the implementation of interventions that will focus on increasing knowledge of malaria prevention and encouraging positive attitudes toward it, as well as promoting regular bed net usage and healthcare seeking behaviors.

Assessing the population's correct knowledge of malaria in Malaysia: a vital component for malaria elimination certification

BACKGROUND

Malaria remains a public health problem in Malaysia despite a decline in the number of cases in recent years. Public knowledge of malaria is essential to achieving and maintaining malaria elimination. Therefore, this survey assessed the prevalence of people who had ever heard of malaria, had correct knowledge of malaria transmission, symptoms, risk activities, and prevention measures in the Malaysian population, and identified the associated factors involved.

METHODS

The data were obtained from the National Health and Morbidity Survey (NHMS) which was conducted from September to October 2020. A cross-sectional survey with five structured questionnaires using the method of computer-assisted telephone interviews (CATI) was used to collect data. The socio-demographic characteristics such as age, gender, ethnicity, nationality, marital status, educational level, and occupation were recorded. Data were analysed using STATA SE Version 16. Associations between variables were tested using chi-square and logistic regression, with the level of statistical significance set at p < 0.05.

RESULTS

Out of 3085 respondents who participated in this survey, 2491 had ever heard of malaria with a prevalence of 76.1% (95% CI 70.5, 80.9). The prevalence of correct knowledge of malaria transmission was 53.9% (95% CI 50.2, 57.7), symptoms 24.1% (95% CI 21.2, 27.2), risk activities 34.0% (95% CI 29.3, 39.1) and prevention measures 59.7% (95% CI 55.5, 63.7). Multivariate analysis showed that age, ethnicity, and educational level were significantly associated with correct malaria transmission and risk activities. In addition, age and educational level were significantly associated with correct malaria symptoms. Subsequently, only the variable ethnicity showed a significant association with the correct malaria prevention measures.

CONCLUSION

In general, the prevalence of ever heard of malaria was considered high since the survey was performed based on a non-specific malaria population. However, the prevalence of correct knowledge of malaria symptoms and risk activities were considered low. It is concluded that educational level is one of the major factors associated with correct malaria knowledge, along with age and ethnicity. Therefore, based on these findings, targeted intervention and innovation should be planned by malaria programme managers to sustain malaria elimination in Malaysia.

Malaria knowledge, attitude, and practice among communities involved in a seasonal malaria chemoprevention study in Nanyumbu and Masasi districts, Tanzania

Background

Utilization of malaria interventions is influenced by, among other things, the level of knowledge and attitude that the community has toward the infection as well as the available interventions. This study assessed malaria knowledge, attitudes, and practices on malaria infection and interventions in Masasi and Nanyumbu districts, Tanzania.

Methods

A community-based cross-sectional survey was conducted between August and September 2020, among the heads of households having at least one under-five child. Information on knowledge, attitudes, and practices on malaria infection and interventions was gathered from the heads of the households using a structured questionnaire. The knowledge level was classified into low, moderate, and high. Attitudes were classified into positive and negative, whereas the practices were classified into good and poor. Children aged between 3 and 59 months were screened for malaria infection using a malaria rapid diagnostic test (mRDT). The proportion of the households' heads with high level of knowledge was the primary outcome. Proportions were compared using Chi-square or fisher's test, and logistic regression analysis was used as appropriate.

Results

A total of 1,556 household heads were interviewed, 1,167 (75.00%) were male, and according to marital status, 1,067 (68.57%) were couples. All the household heads had some knowledge of malaria, but 47.33% (736/1,555) and 13.83% (215/1,555) of them had moderate and high knowledge, respectively. The level of knowledge on malaria was significantly influenced by gender [adjusted odds ratio (aOR) = 0.72, 95.00% confidence interval (CI) = 0.56-0.94, p = 0.017], level of education (aOR = 1.50, 95.00% CI = 1.04-2.16, p = 0.03), and the occupation of the household head (aOR = 1.90, 95.00% CI = 1.22-2.96, p = 0.004). Majority of the households [83.87% (1,305/1,556)] had bed nets hanging on the sleeping spaces. Of the household heads possessing bed nets, 85.10% (514/604), 79.62% (586/736), and 95.35% (205/215) of them had a low, moderate, and high level of knowledge on malaria infection, respectively (trend x ² = 31.53, p < 0.001). The majority [95.04% (1,474/1,551)] of the household heads perceived sleeping under the bed net to be beneficial. Furthermore, 15.56% (94/604), 14.67% (108/736), and 7.44% (16/215) of the household heads with low, moderate, and high knowledge, respectively, had children with malaria infection (trend x ² = 9.172, p = 0.01).

Conclusion

The study population had a good level of knowledge about malaria infection, and a good attitude toward malaria interventions, and the majority of them were using bed nets.

Malaria Preventive Practices among People Residing in Different Malaria-Endemic Settings in a Township of Myanmar: A Mixed-Methods Study

Different villages in a township or an area exhibit different malaria endemicities. This study aimed to investigate malaria preventive practices among people residing in different villages with stratified malaria endemicity in a township in Myanmar. Quantitative data were collected using standardized questionnaires by conducting face-to-face interviews, and qualitative data were obtained through in-depth interviews using a guideline. Quantitative data were analyzed using descriptive statistics and logistic regression models, whereas thematic analysis was used to visualize qualitative data. A total of 360 respondents with similar characteristics participated in the quantitative study. Knowledge regarding malaria and the availability of health information exhibited insignificant differences. Malaria preventive practices were considerably poor among people from moderate- and high-endemic villages (p < 0.05). Adult male farmers or gold miners with low annual family incomes reported poor preventive practices in both moderate- and high-endemic groups. People could not practice some malaria preventive measures because of a lack of resources, e.g., a lack of mosquito repellents. To eliminate the disparities of preventive practices in different malaria-endemic settings, heath-awareness-raising activities should be increased, especially in moderate- and high-endemic villages.

Knowledge, Attitude, and Practice towards Malaria among People Attending Mekaneeyesus Primary Hospital, South Gondar, Northwestern Ethiopia: A Cross-Sectional Study

BACKGROUND

Malaria is one of the most severe public health problems worldwide. It is a leading cause of suffering, death, and socioeconomic problem, especially in many developing countries like Ethiopia. To introduce appropriate preventive and control measures, assessment of community's levels of knowledge, attitude, and preventative practices regarding malaria is crucial. This study was aimed at assessing the knowledge, attitude, and practice (KAP) towards malaria and its preventive and control methods among people attending Mekaneeyesus primary hospital, South Gondar, northwestern Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted from September 2017 to April 2018. A structured questionnaire was administered to collect data on sociodemographic characteristics and KAP of 390 randomly selected individuals. The data collecting tool was pretested before commencing the actual data collection. The data were analyzed using the SPSS version 21 software. P values less than 0.05 were considered statistically significant.

RESULTS

The overall prevalence rate of malaria in the study area was 8.5%. Nearly two-third of the participants had good knowledge (63.1%) and positive attitude (62.6%) scores towards malaria while only half of the participants had (50.8%) good practice score towards malaria prevention and control measures. Sex, age category, family monthly income, residence, and occupational and educational status of the participants were significantly associated with knowledge and practice scores (P < 0.05). The odds of malaria were 26.93 (CI = 3.67-197.47, P = 0.001) and 13.09 (CI = 0.93-183.47, P = 0.036) times higher among individuals who had poor knowledge and poor practice towards malaria, respectively, as compared to individuals who were knowledgeable and had good practice score towards malaria.

CONCLUSION

The overall knowledge score, attitude, and practice level of respondents towards malaria was relatively good. However, significant proportion of the participants still have misconception about the cause, sign and symptoms, modes of transmission, and practices towards prevention methods of malaria. Thus, health education which is aimed at raising community's awareness about the disease is necessary to address the gaps identified by this study.

The acceptability of targeted mass treatment with primaquine for local elimination of vivax malaria in a northern Myanmar township: a mixed-methods study

Background

Radical cure of the Plasmodium vivax latent liver stage is required to effectively manage vivax malaria. Targeted mass treatment with primaquine may be an effective mechanism for reducing reservoirs of the disease. Since community engagement and high coverage are essential for mass treatment programs, this study aimed to determine the acceptability of mass primaquine treatment in a targeted community in a northern Myanmar township.

Methods

A cross-sectional mixed-methods study was deployed among household leaders in July 2019. Face-to-face interviews using structured questionnaires and standardized qualitative guidelines were conducted to gather information. Descriptive and inferential statistics, including logistic regression models, were applied.

Results

Among 609 study respondents, > 90% agreed to participate in an upcoming targeted mass primaquine treatment (TPT) program. Factors contributing to higher odds of acceptability of the program were older age [adjusted odds ratios (aOR): 2.38, 95% confidence intervals (CI) 1.08–8.96], secondary education level (aOR: 3.99, 95% CI 1.12–20.01), having good knowledge of malaria (aOR: 2.12, 95% CI 1.04–4.76), experiencing malaria within the family (aOR: 1.92, 95% CI 1.14–5.13), and believing eliminating malaria from the village is possible (aOR: 2.83, 95% CI 1.07–4.07). Furthermore, 50 community respondents, 6 midwives, and 4 public health staff (grade II) participated in the qualitative component of the study. Many thought that TPT seemed feasible and stressed that high coverage of underserved groups and health education are needed before commencing the activity.

Conclusions

Most respondents agreed to participate in the proposed mass treatment campaign. Older people with secondary education level and those who had experienced malaria within their families were most likely to report willingness to participate. These same individuals may be important in the community engagement process to increase community acceptance of the program.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-05064-y.

Factors associated with social responsibility among university students in Yala, Thailand during the COVID-19 pandemic

Purpose

The objectives of this study were to evaluate knowledge on the coronavirus disease 2019 (COVID-19) transmission, attitude toward the measures of COVID-19 prevention and control, explore social responsibility behaviors and test for the association between variables and social responsibility among university students.

Design/methodology/approach

It was a cross-sectional study. The population was 7,754 students from a university in Yala province. The sample size was 370 students according to Krejcie and Morgan table. Google form was introduced to make the self-administered questionnaires. Content validity was evaluated by three experts, and for reliability of knowledge and attitude, the coefficient was 0.707 and 0.702. Data collection was done in the early April 2020. Descriptive statistics and χ² were used to analyze the data. Ethical approval number 095–63.

Findings

The results found that students' knowledge on COVID-19 transmission was in a moderate level, attitude toward the state measures for COVID-19 prevention and control was at a high level. Their social responsibility behaviors were at a high level. Their knowledge, attitude and payment were significant association with social responsibility behaviors among university students (p < 0.05).

Originality/value

University students' knowledge on disease transmission as well as positive attitude toward the measures of regulation led them to have cooperation. Social distancing and lockdown measures affected their lifestyle. However, they have responsibility behaviors to the society, especially in the pandemic situation.