Survey of Community Knowledge, Attitudes, and Practices During a Malaria Epidemic in Central Java, Indonesia

Abstract

Abstract. We surveyed adults in a randomly selected sample of 1,000 households in 50 villages in nine malarial sub-districts in Purworejo, central Java, Indonesia from May to July 2001. The survey assessed malaria knowledge, attitudes, and practices in communities experiencing epidemic malaria to begin exploring broad strategies for controlling the disease in the region. A pre-tested survey instrument consisting of 93 questions addressed demographic characteristics, socioeconomic factors, knowledge and perceptions of malaria, burden and severity of disease, treatment-seeking behavior, malaria prevention practices, and perceptions of government malaria control efforts. The survey was taken by in-person interview of all subjects. Most (97%) subjects were aware of malaria and more than two-thirds correctly identified mosquitoes as the vector. Forty-one percent of households in both forest/hilly and agricultural/urban areas reported malaria illness in the past year. Thirty-six percent (357 households) owned at least one bed net, 92% of these had been purchased by the owners. However, only 36% of households with bed nets affirmed their use as a means of preventing malaria. Nearly all respondents reported a willingness to accept spraying of residual insecticides for malaria prevention, yet less than 5% were willing to pay a nominal fee (US $3) for this service. Fifty-two percent of respondents reported self-treatment of malaria illness without visiting a health facility. This assessment of knowledge, attitudes, and practices showed a broad awareness of malaria and its consequences among residents of malarial areas in the Menoreh Hills of Central Java.

Indoor Residual Spraying Coverage and Acceptability Rates to Control Malaria and the Householders’ Reasons of Acceptance or Rejection of Spraying, in South-East of Iran

“…The majority of the householders (95.3%) associated mosquito bites with malaria transmission that was similar to other reports from different parts of the world (3,15) and was higher than reported in Southern Mexico (48%) (11) and Ethiopia (56.1%) (12). The high knowledge on malaria preventions, transmission and treatment has considerable impact on the effectiveness of malaria control programs and, therefore, public health education programs should always be implemented to increase the existing knowledge of the entire population for an adequate length of time, to be effective (3).…”

“…A similar finding was reported from Northwestern Tanzania and Southern Mexico (3,15). This acceptance rate was lower than the study conducted by Rodriguez et al in Southern Mexico, with 97.6% (11), and was higher than the study in South Africa (1).…”

“…Its acceptability varied from location to location (14). For example, in Indonesia, a study showed that approximately all householders reported a willingness to accept IRS for malaria prevention (15), whereas this rate was 97.6% in Southern Mexico (11), to 29% -41% throughout the study period, in rural Mozambique (16). In Hlongwana et al study, in South Africa, 29.4% of the respondents reported that they disliked certain aspects of spraying, because of the discoloring of inner walls of their houses, through spraying the insecticide (1).…”

Combined chloroquine, sulfadoxine/pyrimethamine and primaquine against Plasmodium falciparum in Central Java, Indonesia

“…These two indices parallel clinical recovery and almost certainly exacerbate the persistent over-the-counter marketing and unsupervised use of CQ monotherapy. Indeed, surveys of knowledge, attitudes and practices in the region of study[23] affirmed this practice as common. Moreover, CQ remains first-line therapy against vivax malaria, even though accurate diagnostic services to distinguish these species are available to relatively few people.…”

Treatment-seeking behaviour and associated costs for malaria in Papua, Indonesia

“…At the time of this household survey, little data were available on treatment-seeking behaviour, anti-malarial drug use and household costs of treatment for malaria in Indonesia, where malaria remains a significant public health concern [14, 15]. A household survey in 2002–2003 indicated that less than 1% of children under the age of five received an anti-malarial for fever [15].…”