Caregivers’ Malaria Knowledge, Beliefs and Attitudes, and Related Factors in the Bata District, Equatorial Guinea

Abstract

ObjectivesAdequate community knowledge about malaria is crucial in order to improve prevention by reducing exposure to the disease. Malaria is a major cause of morbidity and mortality among children of less than five years of age in Equatorial Guinea. However, information concerning the accuracy of community knowledge is insufficient. This study aimed at assessing the depth of caregivers’ knowledge of malaria, their beliefs and attitudes about this disease, and their socioeconomic determinants in the Bata district of Equatorial Guinea.MethodologyA cross-sectional study was conducted in the district of Bata, involving 440 houses selected from 18 rural villages and 26 urban neighbourhoods. A combined "Malaria Knowledge Score" was generated based on caregivers’ knowledge about transmission, symptoms, prevention, the treatment of children, and best place to seek treatment. Multivariate logistic regressions analyses were performed to assess those factors that are associated with knowledge about malaria.ResultsA total of 428 caregivers were interviewed; 255 (59.6%) and 173 (40.4%) lived in urban and rural areas respectively. Significant differences between rural and urban households were observed in caregivers’ malaria knowledges and beliefs. Almost 42% of urban and 65% of rural caregivers were unaware as to how malaria is transmitted (OR = 2.69; 95% CI: 1.78–4.05). Together with rurality, the factors most significantly associated with the Malaria Knowledge were the level of education of the caregiver and the socioeconomic status of the household.ConclusionsImprovements in educational programs are needed to empower the most vulnerable households such that they can pro-actively implement malaria control measures. This could be achieved by a comprehensive communication strategy aimed at changing individual and community behaviours, and delivered by suitably trained community health workers and indoor residual spraying personnel.

Malaria determining risk factors at the household level in two rural villages of mainland Equatorial Guinea

“…Recent Equatorial Guinea statistical information shows that in 2012, net enrolment in primary education was only 61%, and probably this number is lower in rural populations [ 40 ]. Romay-Barja et al [ 41 ] studied individual knowledge about malaria in Bata district (urban and rural areas) and reported that almost 65% of the individuals living in the rural areas were unaware of how malaria is transmitted and the use of bed nets were mentioned more to prevent mosquito nuisance than for malaria prevention and this lack of information about malaria prevention tools and practices was frequent in both villages.…”

Effectiveness of peer-learning assisted primary school students educating the rural community on insecticide-treated nets utilization in Jimma-zone Ethiopia

“…Studies [49,50] measured specific knowledge items unlike the current study that comprehensively measured knowledge. One study in Equatorial Guinea reported closer value, 35%, of combined knowledge score on malaria among rural sub-groups, which is comparable in terms of study population and measurement [52]. The magnitude of ITN utilization is another variable needing explanation.…”

The use and preference of artemether as a first-choice treatment for malaria: results from a cross-sectional survey in the Bata district, Equatorial Guinea

“…About 156 pharmacies and other drug sellers are located throughout the rural and urban areas of the District. In rural areas, where the majority of the population lives > 3 km from a health facility, CHWs were trained to manage the malaria diagnosis and treatment [ 13 ].…”

“…A malaria knowledge score was created to categorize respondents with poor or good knowledge, including the caregiver’s knowledge about malarial transmission, disease symptoms, prevention, treatment for children, and treatment centres. Good or poor knowledge of malaria disease symptoms, transmission, and prevention was defined as scores above or within and below the overall median, respectively [ 13 ].…”

“…Six years after the introduction of AS/AQ therapy in Equatorial Guinea, adherence to the first-line treatment seems to be non-existent in the Bata district where there is evidence of an alarming use and preference for artemether monotherapy as the first choice for malaria treatment. The Bata population considers artemether the best treatment for malaria, especially in urban areas [ 13 ] and, according to caregiver reports, artemether is the anti-malarial most often administrated to children, regardless of where they seek treatment [ 14 ]. The use of artemisinin monotherapy involves serious risks because adherence to these relatively long treatment regimens is low, leading to parasite resistance and illness recrudescence [ 15 ].…”