Previous Trend, Present Prevalence and Integrated Knowledge, Attitude and Practice Towards Malaria and Use of Insecticide-treated Mosquito Net in the Rural Setting of Welkait District, Northwest Ethiopia

Abstract

Background: Malaria is still a burden to Ethiopia, especially among the productive ages of the society. Although insecticide-treated mosquito nets (INTs) are widely practiced by the rural community, malaria remains a leading public health issue. This study aimed to evaluate a 5-year trend, current prevalence and community knowledge, attitude and practice (KAP) towards malaria and use of ITNs as a strategy for prevention of malaria among the rural setting of Welkait district, northwest Ethiopia.Methods: A cross-sectional study was carried out on 403 households to identify the prevalence rate of malaria. Besides, a 5-year (2015-2019) retrospective data was analyzed. Random sampling technique was used to select representative households among the community members. Well-structured questionnaires were used to collect KAP data towards the utilization of ITNs against malaria infection. Blood samples were examined for identification of malaria parasites following standard procedure. SPSS version 22 was used for the analysis of quantitative data. Results: Of 36,219 outpatients examined, 7,309 (20.2%) malaria-positive cases were reported during 2015-2019. Overall prevalence of malaria was continually declined from 2015-2019. Male slide-confirmed (61.4%, N = 4,485) were significantly higher than female (38.6%, N = 2,824) (p < 005). Nineteen (4.7%) confirmed malaria cases were screened during parasitological survey (12 cases of P. falciparum and 7 cases of P. vivax). Most 78.4% (316) and 84.1% (339) of the respondents knew malaria is a communicable and curable disease respectively and 75.6% (239) of them associated it with mosquito bit. From 82.4% (332) respondents who believed malaria is preventable, 81.0% (269) of respondents considered ITNs as the main prevention method. About 64% (257) of the respondents possessed ITNs, of these, 66.9% (172) consistently used during peak season. Majority 83.6% (337) of the respondents have a positive attitude toward ITNs. Conclusion: Although the retrospective analysis showed a declining trend of malaria in the district, the current prevalence survey revealed a significant increase of malaria in the locality. This was contributed by unsustainable distribution and inconsistent use of ITNs among the population. We recommend the governments and stockholders to give emphasis on full coverage of ITNs and educate the community about ITNs usage.