Malaria knowledge and bed net use in three transmission settings in southern Africa

Abstract

BackgroundInsecticide-treated nets (ITNs) reduce malaria morbidity and mortality in endemic areas. Despite increasing availability, the use of ITNs remains limited in some settings. Poor malaria knowledge is a barrier to the widespread use of ITNs. The goal of this study was to assess the levels of malaria knowledge and evaluate factors associated with bed net use among individuals residing in three regions of southern Africa with different levels of malaria transmission and control.MethodsA cross-sectional study was conducted on a sample of 7535 residents recruited from 2066 households in Mutasa District, Zimbabwe (seasonal malaria transmission), Choma District, Zambia (low transmission) and Nchelenge District, Zambia (high transmission), between March 2012 and March 2017. A standardized questionnaire was used to collect data on demographics, malaria-related knowledge and use of preventive measures. Multivariate logistic regression analyses were used to assess determinants of bed net use.ResultsMost of the 3836 adult participants correctly linked mosquito bites to malaria (85.0%), mentioned at least one malaria symptom (95.5%) and knew of the benefit of sleeping under an ITN. Bed net ownership and use were highest in Choma and Nchelenge Districts and lowest in Mutasa District. In multivariate analyses, knowledge of ITNs was associated with a 30–40% increased likelihood of bed net use after adjusting for potential confounders across all sites. Other factors significantly associated with bed net use were age, household size and socioeconomic status, although the direction, strength and size of association varied by study site. Importantly, participants aged 5–14 years had reduced odds of sleeping under a bed net compared to children younger than 5 years.ConclusionRelevant knowledge of ITNs translated into the expected preventive behaviour of sleeping under a bed net, underscoring the need for continued health messaging on malaria prevention. The implementation and delivery of malaria control and elimination interventions needs to consider socioeconomic equity gaps, and target school-age children to ensure access to and improve utilization of ITNs.

Knowledge, attitudes and practices assessment of malaria interventions in rural Zambia

“…Although most caregivers correctly cited the bite of an infected mosquito as a malaria transmission route, drinking dirty water and eating contaminated food were also reported by some individuals. These findings reflect outcomes from a study in Choma District, Zambia, which found that 1 in 10 study participants linked drinking bad water with malaria and 1 in 5 associated dirty surroundings with malaria [21]. These misconceptions could be due to misunderstandings between cholera and malaria transmission, two diseases that are of priority in education campaigns.…”

“…Studies in Africa have shown that increasing knowledge and awareness of vector control tools may increase the uptake of novel malaria control interventions [16,17]. Repellent products such as mosquito coils, topical repellent creams and spatial repellent emanators have been proven effective to protect against malaria [18][19][20][21][22][23][24]. The current study assessed acceptability of a spatial repellent (SR) product in development.…”

Long Lasting Insecticide-treated Bed Net Ownership, Utilization and Associated Factors Among School-age Children in Dara Mallo and Uba Debretsehay Districts, Southern Ethiopia

“…The ownership of bed net was lower than the coverage estimated in the most recent malaria indicator survey in Ethiopia (13) and most other studies conducted in Ethiopia (21, 24, 28, 29) except a study conducted among households of pregnant mothers in Shashogo district in Southern Ethiopia (22). The nding from the present study was also lower as compared to similar studies conducted outside Ethiopia such as national and district level studies in Uganda (30-32),Madagascar (33), Ghana (34,35), Zimbabwe (36), Equatoria Guinea (37), Yemen (38), among migrant population in Myanmar (39) and in Kenya (40). The higher ownership of bed nets in these countries and speci c study localities might be occurred due to difference in the study population since pregnant mothers and children age less than vers were known to be at higher risk of malaria or timing of data collection relative to the time when the distribution has occurred since some bed nets get lost because of different reasons as time goes on.…”

“…The bed net utilization by SAC in the study area was lower than its utilization by people living in malaria endemic areas in Africa (1). The bed net utilization was lower among this study population (20,21,24,28,29) as compared to pregnant mothers, children age less than ve years in Ethiopia as well as other countries outside Ethiopia like the general population and under ve children in Zimbabwe (36), SAC in Uganda, Tanzania and Yemen (31,38,(40)(41)(42), care givers of under ve children in Ghana (35), SAC and the general population in Kenya (40) and Nigeria (43). These differences could be due to differences on the level of awareness of the targeted population as pregnant women and children age less than ve years were well known high risk population groups than the SAC.…”

Individual and contextual correlates of mosquito net use among women in Nigeria

“…Based on these facts, poor women would avail themselves of the opportunity offered by the availability of mosquito nets. It is also shown in the study that women who claimed that malaria is caused by mosquitoes are more likely to use mosquito nets than those who responded otherwise [26]. This indicates that knowledge about the cause of malaria is an important predictor of mosquito net use.…”