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Musoke D, Lubega GB, Niyongabo F, Nakalawa S, McMorrow S, Wanyenze RK, Kamya MR. Facilitators and barriers to integrated malaria prevention in Wakiso district, Uganda: A photovoice study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002469. [PMID: 38626091 PMCID: PMC11020531 DOI: 10.1371/journal.pgph.0002469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/09/2024] [Indexed: 04/18/2024]
Abstract
Malaria continues to cause significant morbidity and mortality globally, particularly in sub-Saharan Africa. Appropriate combinations of non-chemical and chemical methods of malaria vector control in the context of integrated vector management have been recommended by the World Health Organization. The aim of the study was to explore facilitators and barriers to using integrated malaria prevention in Wakiso district, Uganda. This qualitative study employed photovoice among 20 community members in Kasanje Town Council, Wakiso District. The photos taken by participants for 5 months using smartphones were discussed during monthly meetings with the researchers. The discussions were audio-recorded, and resulting data analysed using thematic analysis with the support of NVivo (2020) QSR International. Findings indicated that various conventional and non-conventional measures were being used for preventing malaria such as: insecticide treated nets; clearing overgrown vegetation; draining stagnant water; mosquito coils; smouldering of cow dung; spraying insecticides; plant repellents near houses; eating of prophylactic herbs; as well as closing doors and windows on houses early in the evening. Facilitators supporting the use of several malaria prevention methods holistically included: low cost and accessibility of some methods such as slashing overgrown vegetation; and support provided for certain methods such as receiving free mosquito nets from the government. Barriers to using several malaria prevention methods holistically included: inadequate knowledge of some methods such as housing improvement; allergic reactions to chemical-based methods such as insecticide treated nets; unaffordability of some methods such as insecticide sprays; and inaccessibility of certain methods such as body repellents. These barriers to integrated malaria prevention need to be addressed to achieve greater impact from the combination of methods in endemic communities.
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Affiliation(s)
- David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Grace B. Lubega
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Filimin Niyongabo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Suzan Nakalawa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Shannon McMorrow
- School of Interdisciplinary Health Programs, Western Michigan University, Kalamazoo, Michigan, United States of America
| | - Rhoda K. Wanyenze
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Moses R. Kamya
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
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Zare M, Vatandoost H, Soleimani-Ahmadi M, Sanei-Dehkordi A, Jaberhashemi SA, Mohseni S. Knowledge and Practices of Women Regarding Malaria and Its Prevention: A Community-Based Study in an Area under Malaria Elimination Programme in Iran. J Arthropod Borne Dis 2023; 17:383-399. [PMID: 38868676 PMCID: PMC11164615 DOI: 10.18502/jad.v17i4.15301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/26/2023] [Indexed: 06/14/2024] Open
Abstract
Background Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are two core interventions for control and prevention of malaria infection. This descriptive cross-sectional study aimed to determine the knowledge and practices of women regarding malaria and its preventive measures in a malarious area in the Jask County, southeast of Iran. Methods Data was collected from 400 households through a two-stage random cluster sampling method in six villages. Pre-tested structured questionnaire was used to collect data. During the survey, visual observations were also made by the interviewers to check use of LLINs and IRS. The data were analyzed by SPSS software version 21. Results The majority of households had a high level of knowledge about symptoms (98%, n=392) and transmission (74.5%, n=298) of malaria. The main preventive measures against malaria were: LLINS (39.5%, n=158), IRS (32%, n=128), and screens on doors/windows (16.7%, n=67). In addition, participants with primary or higher educational level reported that they practice more malaria preventive measures, compared to those who were illiterate (OR=3.3, 95% CI= 1.6-6.6, p=0.0001, Table 6). In spite of positive perceptions about IRS and LLINs, only 35.5% (n=142) and 17% (n=68) of households used IRS and LLINs, respectively. Conclusion According to the results of this study, despite a high level of knowledge about malaria and its preventive measures, a small number of participants use LLINs and IRS for malaria prevention. Therefore, implementation of effective educational interventions is recommended to improve preventive practices against malaria in the study area.
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Affiliation(s)
- Mehdi Zare
- Department of Occupational Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hassan Vatandoost
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Chemical Pollutants and Pesticides, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Moussa Soleimani-Ahmadi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Alireza Sanei-Dehkordi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | - Shokrollah Mohseni
- Student Research Committee, Shiraz University of Medical Science, Shiraz, Iran
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Lwenge M, Govule P, Katongole SP, Dako-Gyeke P. Malaria treatment health seeking behaviors among international students at the University of Ghana Legon. PLoS One 2023; 18:e0276412. [PMID: 37883486 PMCID: PMC10602253 DOI: 10.1371/journal.pone.0276412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Appropriate management of malaria demands early health seeking behaviour upon suspicion of malaria-like symptoms. This study examined malaria treatment seeking behaviour and associated factors among international students at University of Ghana. METHODS The study used a cross-sectional and quantitative approach. Data collection was undertaken using a structured questionnaire administered on a random sample of 264 international students. Data obtained on malaria treatment and factors influencing treatment behaviors were analyzed using IBM, SPSS Statistics version 22. Associations between individual characteristics and Malaria treatment seeking behavior was assessed by Pearson Chi-square(X2) test of independence. Binary logistic regression model was built using a backwards Wald approach, with variables retained at Wald p-value <0.05. RESULTS The findings show that 35% of the respondents obtained self-prescribed antimalarial at their utmost first choice of Malaria treatment. At bivariate level, a significant relationship between Malaria health-care seeking behaviour and:- Respondents continent, X2(1, N = 264) = 7.936, p = .005; Service accessibility, X2(1, N = 264) = 7.624, p = .006; Wait time, X2(1, N = 264) = 22.514, p <0.001; Treatment cost, X2(1, N = 264) = 97.160, p <0.001; Health insurance, X2(1, N = 264) = 5.837, p = 0.016, and Perceived staff attitude, X2(1, N = 264) = 18.557, p < 0.001. At multivariable analysis, inappropriate malaria health seeking behaviours was associated with low perceived service accessibility as (≥30mins) (aOR = 6.67; p<0.001), perceived long wait time (≥30mins), (aOR = 5.94; p = 0.015), perceived treatment cost affordability (<15 GHC) (aOR = 19.88; p<0.001) and age group: -34-41years (aOR = 8.83; p<0.001). CONCLUSION There were widespread inappropriate health-care seeking behavior for Malaria treatment among international students. Improving accessibility to malaria treatment services, reducing wait time at health facilities and the treatment cost will address inappropriate malaria treatment health seeking behaviours among the international students.
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Affiliation(s)
- Mathias Lwenge
- Department of Social and Behavioural Sciences, College of Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
- Faculty of Health Sciences, Uganda Martyrs University, Nkozi, Uganda
| | - Philip Govule
- Department of Epidemiology and Disease Control, College of Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
- Department of Government Studies, School of Management Studies, Uganda Management Institute, Kampala, Uganda
| | - Simon Peter Katongole
- Department of Health Policy, College of Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Phyllis Dako-Gyeke
- Department of Social and Behavioural Sciences, College of Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
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Lopez AR, Brown CA. Knowledge, attitudes and practices regarding malaria prevention and control in communities in the Eastern Region, Ghana, 2020. PLoS One 2023; 18:e0290822. [PMID: 37647322 PMCID: PMC10468076 DOI: 10.1371/journal.pone.0290822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND In sub-Saharan Africa countries including Ghana, the malaria burden remains unacceptably high and still a serious health challenge. Evaluating a community's level of knowledge, attitude, and practice (KAP) regarding malaria is essential to enabling appropriate preventive and control measures. This study aimed to evaluate knowledge of malaria, attitudes toward the disease, and adoption of control and prevention practices in some communities across the Eastern Region of Ghana. METHODS A cross‑sectional based study was carried out in 13 communities across 8 districts from January -June, 2020. Complete data on socio-demographic characteristics and KAP were obtained from 316 randomly selected household respondents by a structured pre-tested questionnaire. Associations between KAP scores and socio-demographic profiles were tested by Chi-square and binary logistic regression. Data analysis was done with SPSS version 26.0. RESULTS Most respondents (85.4%) had good knowledge score about malaria. Preferred choice of treatment seeking place (50.6%) was the health center/clinic. All respondents indicated they would seek treatment within 24 hours. Mosquito coils were the preferred choice (58.9%) against mosquito bites. Majority of households (58.5%) had no bed nets and bed net usage was poor (10.1%). Nearly half of the respondents (49.4%) had a positive attitude toward malaria and 40.5% showed good practices. Chi-square analysis showed significant associations for gender and attitude scores (p = 0.033), and educational status and practice scores (p = 0.023). Binary logistic regression analysis showed that 51-60 year-olds were less likely to have good knowledge (OR = 0.20, p = 0.04) than 15-20 year-olds. Respondents with complete basic schooling were less likely to have good knowledge (OR = 0.33, p = 0.04) than those with no formal schooling. A positive attitude was less likely in men (OR = 0.61, p = 0.04). Good malaria prevention practice was lower (OR = 0.30, p = 0.01) in participants with incomplete basic school education compared to those with no formal schooling. CONCLUSION Overall scores for respondents' knowledge, though good, was not reflected in attitudes and levels of practice regarding malaria control and prevention. Behavioral change communication, preferably on radio, should be aimed at attitudes and practice toward the disease.
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Affiliation(s)
| | - Charles Addoquaye Brown
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle Bu, Accra, Ghana
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Nadia J, Wang Y, Li G, Sun L, Mmadi SA, Abdallah KS, Abdallah AM, Shu L, Bacar A, Deng C, Huang X, Zhou X, Song J, Lu F. KNOWLEDGE, ATTITUDES, AND PRACTICES TOWARD MALARIA AND ANTIMALARIAL MASS DRUG ADMINISTRATION AMONG HEADS OF HOUSEHOLDS IN VILLAGES ON GRANDE COMORE ISLAND, THE COMOROS. J Parasitol 2023; 109:187-199. [PMID: 37270766 DOI: 10.1645/22-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Knowledge, attitudes, and practices (KAP) surveys on malaria and antimalarial mass drug administration (MDA) have not received much attention in the Union of the Comoros. This study is a household-based cross-sectional survey using a multi-stage sampling technique aiming at investigating KAP toward malaria and antimalarial MDA with artemisinin-piperaquine among heads of households on Grande Comore Island, the largest island of the Comoros. A predefined structured questionnaire containing socio-demographic characteristics and questions about malaria and antimalarial MDA was administered to 1,368 randomly selected heads of households from 10 malaria-endemic villages on Grande Comore Island. The results showed that 81.4% of the heads of households knew that malaria is a transmissible disease, 77.6% recognized mosquitoes as the vectors of malaria, and 70.8% recognized fever as one of the frequent symptoms of malaria; 40.8% of respondents remembered the name of the antimalarial drug used for MDA, and 62.1% remembered the color of the antimalarial tablets; and 65.1% chose to go to a public health center to seek treatment as their first option within 24 hr of the onset of initial malaria symptoms. This study found that most heads of households had a reasonable level of knowledge about malaria and antimalarial MDA. However, only 7.3% obtained full points on all knowledge-related questions. Misconceptions about malaria cause, transmission, diagnostic method, and antimalarial MDA exist in the community of Grande Comore Island. As the Comoros continues to put great efforts to go toward malaria elimination, the community's KAP on malaria and antimalarial MDA is crucial to guarantee the community's long-term adherence to malaria elimination interventions and could become key to guaranteeing malarial elimination in the Comoros. Therefore, there is a great need to improve malaria prevention awareness through strengthening malaria education and promoting behavioral change. Heads of households should be the core target of malaria education and behavioral change for malaria elimination.
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Affiliation(s)
- Julie Nadia
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou 510440, China
| | - Yuxin Wang
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou 510440, China
| | - Guoming Li
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou 510440, China
| | - Liwei Sun
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou 510440, China
| | - Salim Abdoulkarim Mmadi
- Ministry of Health, Social Cohesion, Solidarity, and Gender Promotion, Bâtiment de la Fonction Publique, BP 1028, Moroni, the Union of the Comoros
| | - Kamal Said Abdallah
- National Malaria Control Program, Route de la Corniche, BP 5212, Moroni, the Union of the Comoros
| | - Ali Maoulida Abdallah
- Ministry of Health, Social Cohesion, Solidarity, and Gender Promotion, Bâtiment de la Fonction Publique, BP 1028, Moroni, the Union of the Comoros
| | - Lei Shu
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou 510440, China
| | - Affane Bacar
- National Malaria Control Program, Route de la Corniche, BP 5212, Moroni, the Union of the Comoros
| | - Changsheng Deng
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Xinan Huang
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Xian Zhou
- Science and Technology Park, Guangzhou University of Chinese Medicine, Guangzhou 510440, China
| | - Jianping Song
- Artemisinin Research Center, Guangzhou University of Chinese Medicine, Guangzhou 510405, China
- First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
| | - Fangli Lu
- Clinical Laboratory, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, China; Department of Parasitology, School of Medicine, Sun Yat-sen University, Shenzhen 518107, China; Department of Parasitology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China; and Key Laboratory of Tropical Disease of the Ministry of Education, Sun Yat-sen University, Guangzhou 510080, China
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Socio-demographic trends in malaria knowledge and implications for behaviour change interventions in Zanzibar. Malar J 2023; 22:39. [PMID: 36732822 PMCID: PMC9896669 DOI: 10.1186/s12936-023-04472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Zanzibar is among the few places within East Africa that have documented a significant reduction of malaria morbidity and mortality. Despite tremendous gains over the past decade, malaria transmission still persists in Zanzibar. This study aimed at understanding levels of malaria knowledge to provide recommendations that can be used to reinforce and scale up targeted malaria social and behaviour change interventions. METHODS A descriptive cross-sectional survey was conducted through an administered questionnaire to 431 households selected randomly. The interviewees were the heads of household or representative adults above 18 years. This study investigated the levels of knowledge about the causes, symptoms, and prevention of malaria in areas with high (> 1.9 per 1000) and low (< 1 per 1000) incidence of local malaria cases. The Principal Component Analysis (PCA) was used to compute the composite variable of each category. Descriptive statistics were calculated to understand variables of interest between low and high transmission areas. Multinomial logistic regression model was used to compare knowledge on malaria based on key variables. RESULTS A total of 431 heads of households were interviewed. Respondent age, education level, and wealth status were significantly associated with variations in level of malaria knowledge. Old age was found to be significantly associated with low knowledge of malaria (P < 0.001). The majority of study participants who had secondary and higher education levels had good knowledge of malaria (P < 0.006). Participants characterized as middle-income had good knowledge compared to those characterized as low-income (P < 0.001). CONCLUSION The study identified existing gaps in malaria knowledge in low and high transmission areas. Low levels of malaria knowledge were documented among elderly and populations with lower education and income levels. There is a need to extend mobilization, advocacy, and expand channels of communication to reach all community members. The reported gaps in knowledge are important to consider when designing strategies to engage communities in malaria elimination in Zanzibar. Tailored social and behavioural change interventions aiming to increase malaria knowledge could enhance the uptake of malaria prevention services in the community.
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Ngasala B, Mwaiswelo RO, Chacky F, Molteni F, Mohamed A, Lazaro S, Samuel B, Mmbando BP. Malaria knowledge, attitude, and practice among communities involved in a seasonal malaria chemoprevention study in Nanyumbu and Masasi districts, Tanzania. Front Public Health 2023; 11:976354. [PMID: 36875425 PMCID: PMC9975554 DOI: 10.3389/fpubh.2023.976354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
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.
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Affiliation(s)
- Billy Ngasala
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Richard O Mwaiswelo
- Department of Microbiology, Immunology and Parasitology, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Frank Chacky
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Fabrizio Molteni
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Ally Mohamed
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Samwel Lazaro
- National Malaria Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Bushukatale Samuel
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno P Mmbando
- Tanga Research Centre, National Institute for Medical Research, Tanga, Tanzania
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Orish VN, Maalman RSE, Donkor OY, Ceruantes BYH, Osei E, Amu H, Appiah PK, Konlan KD, Mumuni H, Kim E, Kim S, Jung H, Ofori-Amoah J, Kofie P, Adjuik M, Alhassan RK, Donkor ES, Zottor FB, Kweku M, Amuna P, Kim SY, Gyapong JO. Assessing health-seeking behaviour and malaria prevention practices among communities in four districts of the Volta Region of Ghana. Malar J 2021; 20:450. [PMID: 34838027 PMCID: PMC8626995 DOI: 10.1186/s12936-021-03986-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022] Open
Abstract
Background Malaria is a preventable disease that causes huge morbidity and mortality in malaria-endemic areas, especially among children and pregnant women. The malaria control programme focuses on the prevention of mosquito bites using insecticide-treated nets (ITNs) and mosquito aerosol sprays and coils, as well as prevention of severe disease among those infected through prompt and adequate treatment. The success of the malaria control programme in Ghana is dependent on the malaria prevention practices of people in the community. Therefore, this study evaluated the malaria prevention practices of participants in four districts of the Volta Region of Ghana. Methods This was a cross-sectional study conducted in Ketu South, Nkwanta South, Hohoe Municipality and Ho West districts of the Volta Region of Ghana. Questionnaire were administered to adults who consented to each household visited. Questions were asked on the socio-demographics and malaria prevention practices of the households. Data analysis was done using SPSS version 23 with frequency distribution done for all the variables. Pearson chi-square was used to determine the significant association between socio-demographics and malaria prevention practices, and Multivariate nominal logistic regression analysis was used to model the relationship between dichotomous dependent variables (ITN ownership and usage) and independent variables. Results Out of the 2493 participants; 2234 (89.6%) owned ITN and 1528 (68.4%) used ITN a night before this study, 768 (30.8%) used mosquito aerosol spray and 368 (15%) used mosquito coil. More females significantly owned ITN than males (1293, 92.4%, p ≤ 0.001). Participants from Ketu South had 1.5 times higher odds of owning an ITN compared to Ho West whose odds are not different from Nkwanta South or Hohoe (AOR, 1.56 [95% 1.09–2.22]; p = 0.01). In terms of ITN usage, participants in Nkwanta South were less likely to use ITN compared to the other districts; AOR, 0.434 [95% CI 0.31–0.62, p < 0.001]. Also, of the 668 participants that had a fever within the past 3 days, 268 (40.1%) visited a patent medicine store and 156 (23.4%) visited health facilities. Conclusion There is high ownership of ITNs, but relatively low utilization among the community members. Education on malaria prevention practices should be intensified and continuous among the population of the Volta Region to ensure the success of malaria control in the region.
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Affiliation(s)
- Verner N Orish
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | | | - Otchere Y Donkor
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | | | - Eric Osei
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.,Department of Public Health Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Hubert Amu
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Prince Kubi Appiah
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.,Department of Public Health Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Kennedy Diema Konlan
- Department of Public Health Graduate School, Yonsei University, Seoul, Republic of Korea.,School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Hadiru Mumuni
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Eunji Kim
- Korea Foundation for International Healthcare Ghana Office, Accra, Ghana
| | - Siwoo Kim
- Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Hajun Jung
- Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Jones Ofori-Amoah
- School of Medicine, University of Health and Allied Sciences, Ho, Ghana
| | - Philip Kofie
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Martin Adjuik
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kaba Alhassan
- Directorate of International Affairs, University of Health and Allied Sciences, Ho, Ghana
| | | | | | - Margaret Kweku
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Paul Amuna
- School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - So Yoo Kim
- Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - John Owusu Gyapong
- Office of the Vice-Chancellor, University of Health and Allied Sciences, Ho, Ghana
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Kebede Y, Hayder A, Girma K, Abamecha F, Alemayehu G, Abebe L, Sudhakar M, Birhanu Z. Primary school students' poetic malaria messages from Jimma zone, Oromia, Ethiopia: a qualitative content analysis. BMC Public Health 2021; 21:1688. [PMID: 34530799 PMCID: PMC8447558 DOI: 10.1186/s12889-021-11641-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 08/19/2021] [Indexed: 11/29/2022] Open
Abstract
Background The engagement of schools in malaria control is an emerging strategy. Little is known about the involvement of students in the development of malaria messages. This study evaluated the message content of primary school students’ malaria poems. Methods A qualitative content analysis was conducted to explore malaria messages conveyed in poems produced by students. Twenty poems were purposively selected from twenty schools across rural villages in five districts of the Jimma Zone. Data were analyzed using Atlas.ti version 7.1.4 software. The message contents were quantified in terms of frequency, and including metaphors, presented using central themes, categories, and supportive quotations. Results A total of 602 malarial contents were generated, and organized into 21 categories under five central themes. 1) Malaria-related knowledge (causation and modes of transmission, mosquito breeding and biting behavior, signs and symptoms, care for insecticide-treated nets (ITNs), and prevention methods), 2) Perceived threats from malaria, 3)The effectiveness of prevention methods (i.e., related to the adaption of ITNs, environmental cleaning, indoor residual spray (IRS), treatment for fever, and drug adherence practices), 4) Misconceptions, beliefs, and malpractices regarding the cause of malaria and drug use) and 5) Direct calls to the adopt ITN, IRS, clean surroundings, treatment, and drug use. The most commonly conveyed message contents were about the severity of malaria, distinguishable signs and symptoms, calls for community participation for malaria elimination, knowledge of preventive methods, and effectiveness of ITN use. Metaphoric expressions (war and death) were used to convey messages about the severity and the need to manage the prognosis of malaria through the active ITN use, which itself was metaphorically represented as ‘a trap’ to mosquitoes. Conclusions The poetic analysis indicated that the students developed and disseminated rich malarial messages, especially on malarial knowledge, and perceptions, beliefs, norms and practices of the local community to prevent and control malaria. Therefore, primary school students can be a source of information and would effectively communicate knowledge, perceptions, and promote malaria related practices, particularly in rural settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11641-8.
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Affiliation(s)
- Yohannes Kebede
- Department of Health, Behavior, and Society, Jimma University, Jimma, Oromia, Ethiopia.
| | - Abdu Hayder
- Mizan-Tepi University, College of Public Health, Mizan, Ethiopia
| | - Kasahun Girma
- Department of Health, Behavior, and Society, Jimma University, Jimma, Oromia, Ethiopia
| | - Fira Abamecha
- Department of Health, Behavior, and Society, Jimma University, Jimma, Oromia, Ethiopia
| | - Guda Alemayehu
- President's Malaria Initiative, United States Agency for International Development, Addis Ababa, Ethiopia
| | - Lakew Abebe
- Department of Health, Behavior, and Society, Jimma University, Jimma, Oromia, Ethiopia
| | - Morankar Sudhakar
- Department of Health, Behavior, and Society, Jimma University, Jimma, Oromia, Ethiopia
| | - Zewdie Birhanu
- Department of Health, Behavior, and Society, Jimma University, Jimma, Oromia, Ethiopia
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Musoke D, Namata C, Ndejjo R, Ssempebwa JC, Musoke MB. Integrated malaria prevention in rural communities in Uganda: a qualitative feasibility study for a randomised controlled trial. Pilot Feasibility Stud 2021; 7:155. [PMID: 34376257 PMCID: PMC8352755 DOI: 10.1186/s40814-021-00894-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/30/2021] [Indexed: 11/25/2022] Open
Abstract
Background A randomised controlled trial (RCT) on integrated malaria prevention, which advocates the use of several malaria prevention methods holistically, has been proposed. However, before conducting an RCT, it is recommended that a feasibility study is carried out to provide information to support the main study, particularly for such a complex intervention. Therefore, a feasibility study for an RCT on integrated malaria prevention in Uganda was conducted. Methods The qualitative study carried out in Wakiso District employed focus group discussions (FGDs) and key informant interviews (KIIs) to explore community willingness to participate in the RCT as well as assess stakeholder perspectives on the future study. The participants of the FGDs were community members, while the key informants were selected from malaria stakeholders including Ministry of Health officials, health practitioners, local leaders, district health team members, and community health workers (CHWs). Thematic analysis was employed with the support of NVivo. Results A total of 12 FGDs and 19 KIIs were conducted. Five main themes emerged from the study: malaria prevention practices related to integrated malaria prevention; preferred malaria prevention methods in the integrated approach; potential challenges of integrated malaria prevention; perspectives on the proposed RCT; and sustainability of integrated malaria prevention. Despite a few methods being employed holistically in the community, insecticide-treated nets were the most widely used and preferred method for malaria prevention mainly because they were provided free by the government. The main challenges in the integrated approach were the high cost of some methods such as house screening, and concerns about the potential side effects of insecticide-based methods such as indoor residual spraying. Participants expressed high willingness to participate in the RCT to promote the use of multiple methods in their households and community. Involvement of CHWs during implementation was proposed as a sustainability strategy for the RCT interventions. Conclusion There was high willingness to participate in the proposed RCT on integrated malaria prevention. However, high cost and perceived negative health effects from some methods were identified as potential challenges. The type of methods to be included as well as sustainability mechanisms needs to be considered during the design of the RCT.
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Affiliation(s)
- David Musoke
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Carol Namata
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - John C Ssempebwa
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Miph B Musoke
- Department of Applied Sciences, School of Sciences, Nkumba University, Entebbe, Uganda
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Malaria prevention knowledge, attitudes, and practices in Zambezia Province, Mozambique. Malar J 2021; 20:293. [PMID: 34193162 PMCID: PMC8247150 DOI: 10.1186/s12936-021-03825-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/17/2021] [Indexed: 11/15/2022] Open
Abstract
Background In Mozambique, socio-economic and cultural factors influence the wide adoption of disease preventive measures that are relevant for malaria control strategies to promote early recognition of disease, prompt seeking of medical care, sleeping under insecticide-treated nets (ITNs), and taking intermittent preventive treatment for pregnant women. However, there is a critical information gap regarding previous and ongoing malaria social and behavioural change (SBC) interventions. The aim of this study is to assess the knowledge, attitudes, practices of beneficiaries of SBC interventions. Methods A descriptive cross-sectional survey was undertaken in 2018 in two rural districts of Zambezia Province, Mozambique. A structured questionnaire was administered to 773 randomly selected households. Respondents were the adult heads of the households. Descriptive statistics were done. Results The main results show that 96.4% of respondents recalled hearing about malaria in the previous 6 months, 90.0% had knowledge of malaria prevention, and 70.0% of preventive measures. Of the 97.7% respondents that had received ITNs through a mass ITN distribution campaign, 81.7% had slept under an ITN the night before the survey. In terms of source of health information, 70.5% mentioned the role of community volunteers in dissemination of malaria prevention messages, 76.1% of respondents considered worship places (churches and mosques) to be the main places where they heard key malaria prevention messages, and 79.1% asserted that community dialogue sessions helped them better understand how to prevent malaria. Conclusions Results show that volunteers/activists/teachers played an important role in dissemination of key malaria prevention messages, which brought the following successes: community actors are recognized and people have knowledge of malaria transmission, signs and symptoms, preventive measures, and where to get treatment. There is, however, room for improvement on SBC messaging regarding some malaria symptoms (anaemia and convulsions) and operational research is needed to ascertain the drivers of malaria prevalence and inform the SBC approach.
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Fikrie A, Kayamo M, Bekele H. Malaria prevention practices and associated factors among households of Hawassa City Administration, Southern Ethiopia, 2020. PLoS One 2021; 16:e0250981. [PMID: 33984022 PMCID: PMC8118284 DOI: 10.1371/journal.pone.0250981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 04/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite it is easily preventable; malaria is still remains to be a major public health problem in globally as well as in Ethiopia. The disease can be easily prevented through individual and societal combined efforts by keeping the environment safe, effective utilization of long lasting Insecticide Nets and early treatment. However, the factors for poor knowledge and practices of malaria prevention is not well studied in Ethiopia; particularly, in the study area. Hence, this study aimed to provide concrete evidence towards malaria prevention practices and associated factors among Households of Hawassa City Administration, Southern Ethiopia, 2020. METHOD A community-based cross-sectional study was conducted among a randomly selected 598 households at Hawassa City Administration from April 1-15, 2020. Multistage sampling technique was employed to recruit the study households. Data were collected by trained data collectors through a face-to-face interview with pretested structured questionnaire, which was adapted from previous peer reviewed articles. Then the data were checked for the completeness and consistencies, then, coded and entered into Epi data 3.1 and it was exported to SPSS IBM version 23 for analysis. Descriptive mean with standard deviation was used to summarize the continuous variables. Bivariable and multivariable logistic regression model was used to assess factors affecting prevention and control of Malaria. Finally, adjusted odds ratio together with 95% CI and p-value <0.05 was used to declare the statistical significances. RESULTS The overall 317 (54.3%) of households practiced good measure of malaria prevention and control measures. Urban residence [AOR = 1.95 (95%CI: 1.17-3.24)], Secondary school completed [AOR = 5.02(95%CI 2.24-12.03)], Tertiary school completed [AOR = 7.27(95%CI: 2.84-18.55)], Positive Attitude [AOR = 8.20(95%CI: 5.31-12.68)] and Good knowledge about malaria [AOR = 2.81(95%CI: 1.78-4.44)] were significantly associated with malaria prevention practices. CONCLUSIONS Nearly half of the households were still practiced poor measure of malaria prevention and control measures. Hence, health officials and stake holders need attention by providing continuous health education and follow up to control malaria.
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Affiliation(s)
- Anteneh Fikrie
- School of Public Health, College of Health and Medical Sciences, Bule Hora University, Bule Hora, Oromia, Ethiopia
- Public Health Department, Pharma College Hawassa Campus, Hawassa, Sidama, Ethiopia
| | - Mihiret Kayamo
- Public Health Department, Pharma College Hawassa Campus, Hawassa, Sidama, Ethiopia
| | - Henok Bekele
- Public Health Department, Pharma College Hawassa Campus, Hawassa, Sidama, Ethiopia
- Malaria Prevention, Control and Elimination Program Technical Advisory in South Nation Nationalities Peoples Regional State, Southern Ethiopia
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13
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Munzhedzi M, Rogawski McQuade ET, Guler JL, Shifflett PE, Krivacsy S, Dillingham R, Bessong PO. Community knowledge, attitudes and practices towards malaria in Ha-Lambani, Limpopo Province, South Africa: a cross-sectional household survey. Malar J 2021; 20:188. [PMID: 33865394 PMCID: PMC8052774 DOI: 10.1186/s12936-021-03724-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/04/2021] [Indexed: 11/21/2022] Open
Abstract
Background Malaria remains a global health concern and is endemic in Limpopo, Mpumalanga and KwaZulu Natal Provinces of South Africa, which aims to eliminate malaria by 2025. Community engagement plays a significant role in improving the acceptability and effectiveness of programmes aimed at reducing malaria transmission. The success of such intervention efforts depends on the knowledge, attitudes and practices (KAP) of the community, and understanding the KAP of community residents may support malaria control efforts in the locality. In this context, a cross-sectional household survey to assess community KAP on malaria transmission and prevention in the Ha-Lambani village, Vhembe District, Limpopo Province was conducted. Methods Data were collected between November 2018 and May 2019 by questionnaire of 261 consenting adults (213 females and 48 males, aged between 18 and 95 years) selected from different households. Also, a focus group discussion among 13 randomly selected participants was conducted. Pearson’s Chi Square test was used to determine statistical differences by village. Results Study participants (100%, 261/261) were aware of the presence of malaria in their community and 95% associated it with mosquito bites. The local health clinic was the most prominent source of malaria information (85%). Only 22% correctly identified headache, chills and fever as the three most common symptoms of malaria. The majority of participants (98%) knew that effective medication for malaria is available and had a positive treatment-seeking behaviour. Knowledge of malaria prevention measures was high (82%); contrarily, 97% of respondents did not sleep under a bed net the previous night. The focus group data concurred with these results and also revealed that poor bed net use resulted from lack of access to bed nets because community residents could not afford them. Conclusions The study demonstrates that participants have appropriate knowledge about malaria transmission and a positive treatment-seeking behaviour. However, economic barriers are responsible for the inadequate use of bed nets. Therefore, distribution of bed nets to the community should be considered to improve practice of malaria prevention measures. Furthermore, knowledge of signs and symptoms and appropriate malaria treatment was limited, and initiatives to improve awareness on these topics should be continued. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03724-z.
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Affiliation(s)
- Mukhethwa Munzhedzi
- HIV/AIDS & Global Health Research Programme, and Department of Microbiology, University of Venda, Limpopo Province, Thohoyandou, South Africa.
| | | | - Jennifer L Guler
- Department of Biology, University of Virginia, Charlottesville, VA, USA
| | - Piper E Shifflett
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Sara Krivacsy
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Rebecca Dillingham
- Center for Global Health Equity, Department of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Pascal O Bessong
- HIV/AIDS & Global Health Research Programme, and Department of Microbiology, University of Venda, Limpopo Province, Thohoyandou, South Africa.,Center for Global Health Equity, Department of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
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Demissie GD, Ayele TA, Wami SD, Sisay MM, Fetene D, Wolde HF, Akalu TY, Gelaye KA. Low practice of malaria prevention among migrants and seasonal farmworkers in Metema and west Armacheho districts, Northwest Ethiopia. BMC Infect Dis 2021; 21:145. [PMID: 33541286 PMCID: PMC7863355 DOI: 10.1186/s12879-021-05853-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 01/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than hundreds and thousands of migrants and seasonal farm workers move from the highlands (relatively low malaria endemicity areas) to the lowlands (higher malaria endemicity areas) for the development of the corridor of the Amhara region during planting, weeding, and harvesting seasons in each year. Seasonal migrant workers are at high risk of malaria infection. Therefore, evidence of their knowledge level and practice in the prevention of malaria during their stay would be important. OBJECTIVE The aims of this study was to assess the knowledge and practice of malaria prevention and associated factors among migrants and seasonal farm workers in Northwest Ethiopia. METHOD A cross-sectional study was conducted from October to November, 2018 in Metema and West Armacheho districts, northwest Ethiopia. A sample of about 950 migrants and seasonal farm workers were included using two stages of cluster sampling technique. Interview administered structured questionnaire was used. Both bi-variable and multivariable binary logistic regressions were applied to identify predictors of malaria prevention. RESULT The overall good knowledge of malaria (those participants who scored more than 60% of correct response for knowledge related questions) was 50.2% with 95% CI (47.0-53.0) and the overall good practice of malaria (those participants who practiced more than 60% for practice related questions) was 27.2% with 95% CI (244.3-29.9). Age (AOR = 0.51(95%CI; 0.33-0.80)), level of education (AOR = 0.55(95%CI; 0.32-0.94)), using mass media as a source of information (AOR = 2.25(95%CI; 1.52-3.32)) and length of stay at the farming site (AOR = 0.59(95%CI; 0.44-0.79)) were significantly associated with knowledge of malaria prevention. Knowledge (AOR = 6.62(95%CI; 4.46-9.83)), attitude (AOR = 2.17(95%CI1.40-3.37), use of mass media (AOR = 1.64(95%CI; 1.30-2.60)) and the length of stay (AOR = 1.93(95%CI; 1.35-2.77)) in the farming area were significantly associated with practice of malaria prevention. CONCLUSION The practice of malaria prevention among migrant and seasonal farm workers was low. The programmers and implementers should design tailored malaria intervention programs and strategies for these hard to reach population.
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Affiliation(s)
- Getu Debalkie Demissie
- Department of Health Education and Behavioral Science, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
| | - Tadesse Awoke Ayele
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Daba Wami
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Malede Mequanent Sisay
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Destaw Fetene
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Haileab Fekadu Wolde
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Temesgen Yihunie Akalu
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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DePina AJ, Dia AK, de Ascenção Soares Martins A, Ferreira MC, Moreira AL, Leal SV, Pires CM, Moreira JMG, Tavares MF, da Moura AJF, Pereira JM, Faye O, Seck I, Niang EHA. Knowledge, attitudes and practices about malaria in Cabo Verde: a country in the pre-elimination context. BMC Public Health 2019; 19:850. [PMID: 31262268 PMCID: PMC6604228 DOI: 10.1186/s12889-019-7130-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/09/2019] [Indexed: 02/08/2023] Open
Abstract
Background Malaria in Cape Verde is unstable, with a sporadic and seasonal transmission of low endemicity. In this sense, the community perceptions regarding malaria transmission, their attitudes and practices against the disease are very important to understand and to better develop the best strategical policies to achieve malaria elimination goal. This study aim to assess the knowledge, attitudes and practices (KAP) of Cape Verdean population about malaria, a country in the elimination step of disease. Methods A cross-sectional malaria KAP Survey was performed at the household level. A structured open questionnaire was developed and applied to residents of randomly selected households from 5 islands and 15 municipalities in Cape Verde. Correlation analyses were performed using a logistic regression model to determine the factors that are associated with the complete knowledge of the population about malaria. Results A total of 1953 fully completed questionnaires were analysed, with majority of questionnaires administered in Santiago island (68.3%), mainly in the capital city of Praia, 38.43%. About 88% of the population knew the correct form of transmission, 96% had knowledge that the entire population is at risk of malaria and identified the main symptoms. Regarding the attitudes, 58% seek treatment atthe nearest health structure upon the apparition of the symptoms, 64% in the first 24 h and 88% within the first 48 h. More than 97% have heard about mosquito nets but only 19% used it. In practice, 53% use coils, 45% rely on household sprays and 43% have benefited from IRS. About 90% received information about malaria from media, mainly the TV and the radio (83 and 43%, respectively). In summary, 54% of the population has complete knowledge of the disease. Conclusion The population of Cape Verde has a high level of knowledge about malaria, including its transmission, main symptoms and preventive and control measures. However, some gaps and misunderstandings have been noticed and contribute to the insufficient community involvement in actions against malaria. Therefore, is necessary to increase the knowledge of the population, leading to their full ownership and participation in community actions to contribute to the malaria elimination in the country. Electronic supplementary material The online version of this article (10.1186/s12889-019-7130-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adilson José DePina
- Ecole Doctorale des Sciences de la Vie, de la Santé et de l'Environnement (ED-SEV), Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal. .,Programa de Pré-Eliminação do Paludismo, CCS-SIDA. Ministério da Saúde e da Segurança Social, Avenida Cidade Lisboa, Prêdio Bô Casa, 1° Andar; CP, 855, Praia, Cabo Verde.
| | - Abdoulaye Kane Dia
- Laboratoire d'Ecologie Vectorielle et Parasitaire, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
| | | | - Maria Celina Ferreira
- Unidade de Seguimento e Avaliação, CCS-SIDA. Ministério da Saúde e da Segurança Social, Praia, Cabo Verde
| | - António Lima Moreira
- Programa Nacional de Luta contra o Paludismo, Ministério da Saúde e da Segurança Social, Praia, Cabo Verde
| | - Silvania Veiga Leal
- Laboratório de Entomologia Médica, Instituto Nacional de Saúde Pública, Praia, Cabo Verde.,Unidade de Unidade Microbiologia Médica; Departamento de Virologia, Instituto de Higiene e Medicina Tropical, Lisbon, Portugal
| | - Cecílio Mendes Pires
- Laboratório de Análises Clínica, Hospital Regional de Santiago Norte, Assomada, Cabo Verde
| | | | - Maria Filomena Tavares
- Rede Nacional de Laboratório, Ministério da Saúde e da Segurança Social, Praia, Cabo Verde
| | | | - José Manuel Pereira
- Faculdade de Ciências e Tecnologia, Universidade de Cabo Verde, Praia, Cabo Verde.,Laboratório de Engenharia Civil, Praia, Cabo Verde
| | - Ousmane Faye
- Laboratoire d'Ecologie Vectorielle et Parasitaire, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
| | - Ibrahima Seck
- Institut de Santé et Développement, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal
| | - El Hadji Amadou Niang
- Laboratoire d'Ecologie Vectorielle et Parasitaire, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD) de Dakar, Dakar, Sénégal.,Aix Marseille Univ, IRD, AP-HM, MEPHI, IHU-Méditerranée Infection, Marseille, France
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16
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Musoke D, Karani G, Morris K, Ndejjo R, Atusingwize E, Guwatudde D, Musoke MB. Integrated approach to malaria prevention at household level in rural communities in Wakiso district, Uganda: impact evaluation of a pilot project. Afr Health Sci 2018; 18:1144-1156. [PMID: 30766580 PMCID: PMC6354846 DOI: 10.4314/ahs.v18i4.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The integrated approach to malaria prevention, which advocates for the use of several malaria prevention methods at households, is being explored to complement other existing strategies. We implemented a pilot project that promoted the integrated approach to malaria prevention in two rural communities in Wakiso district, Uganda. Objectives This paper presents the impact evaluation findings of the project carried out 2 years after implementation with a focus on changes in knowledge and practices on malaria prevention. Methods The project evaluation was cross-sectional in design and employed both quantitative and qualitative data collection methods. The quantitative survey was conducted among 540 households (household heads being participants) while the qualitative component involved 4 focus group discussions among community health workers (CHWs). Chi-square test was used to compare quantitative results from the evaluation with those of the baseline while thematic analysis was employed for qualitative data. Results There was a statistically significant positive change in malaria prevention practices in the evaluation compared with the baseline regarding indoor residual spraying (χ2 = 7.9, p = 0.019), mosquito screening of windows and ventilators (χ2 = 62.3, p = 0.001), and closing windows of houses before 6:00 pm (χ2 = 60.2, p < 0.001). The CHWs trained during the project were found to be highly knowledgeable on the various malaria prevention methods in the integrated approach, and continued to promote their use in the community. Conclusion Findings of the impact evaluation give promise that utilisation of integrated malaria prevention can be enhanced if use of multiple methods is promoted in communities.
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Malaria prevention practices and associated environmental risk factors in a rural community in Wakiso district, Uganda. PLoS One 2018; 13:e0205210. [PMID: 30300396 PMCID: PMC6177175 DOI: 10.1371/journal.pone.0205210] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 09/20/2018] [Indexed: 12/02/2022] Open
Abstract
Background Besides use of insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS), other complimentary measures including suitable housing structures, and environmental management that reduce breeding of malaria vectors, can be implemented at households to prevent the disease. However, most studies on malaria prevention have focused mainly on ITNs and IRS. The aim of this study was therefore to assess malaria prevention practices beyond ITNs and IRS, and associated environmental risk factors including housing structure in rural Wakiso district, Uganda. Methods A clustered cross-sectional survey was conducted among 727 households in Wakiso district. Data were collected using an interviewer-administered questionnaire and observational checklist. The questionnaire assessed participants’ household practices on malaria prevention, whereas the checklist recorded environmental risk factors for malaria transmission, and structural condition of houses. Poisson regression modeling was used to identify factors associated with use of mosquito nets by households. Results Of the 727 households, 471 (64.8%) owned at least one mosquito net. Use of mosquito nets by households was higher with increasing education level of participants—primary (aPR = 1.27 [95% CI: 1.00–1.60]), secondary (ordinary level) (aPR = 1.47 [95% CI: 1.16–1.85]) and advanced level / tertiary (aPR = 1.55 [95% CI: 1.19–2.01]), and higher household income (aPR = 1.09 [95% CI: 1.00–1.20]). Additionally, participants who were not employed were less likely to have mosquito nets used in their households (aPR = 0.83 [95% CI: 0.70–0.98]). Houses that had undergone IRS in the previous 12 months were 42 (5.8%), while 220 (43.2%) households closed their windows before 6.00 pm. Environmental risk factors found at households included presence of vessels that could potentially hold water for mosquito breeding 414 (56.9%), and stagnant water in compounds 144 (19.8%). Several structural deficiencies on houses that could promote entry of mosquitoes were found such as lack of screening in ventilators 645 (94.7%), and external doors not fitting perfectly into walls hence potential for mosquito entry 305 (42.0%). Conclusion There is need to increase coverage and utilisation of ITNs and IRS for malaria prevention in Wakiso district, Uganda. In addition, other malaria prevention strategies such as environmental management, and improving structural condition of houses are required to strengthen existing malaria prevention approaches.
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Kaindoa EW, Finda M, Kiplagat J, Mkandawile G, Nyoni A, Coetzee M, Okumu FO. Housing gaps, mosquitoes and public viewpoints: a mixed methods assessment of relationships between house characteristics, malaria vector biting risk and community perspectives in rural Tanzania. Malar J 2018; 17:298. [PMID: 30119666 PMCID: PMC6098617 DOI: 10.1186/s12936-018-2450-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/09/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND House improvement and environmental management can significantly improve malaria transmission control in endemic communities. This study assessed the influence of physical characteristics of houses and surrounding environments on mosquito biting risk in rural Tanzanian villages, and examined knowledge and perceptions of residents on relationships between these factors and malaria transmission. The study further assessed whether people worried about these risks and how they coped. METHODS Entomological surveys of indoor mosquito densities were conducted across four villages in Ulanga district, south-eastern Tanzania. The survey involved 48 sentinel houses sampled monthly and other sets of 48 houses randomly recruited each month for one-off sampling over 12 months. Physical characteristics of the houses and surrounding environments were recorded. Questionnaire surveys were administered to 200 household heads to assess their knowledge and concerns regarding the observed housing and environmental features, and whether they considered these features when constructing houses. Focus group discussions, were conducted to clarify emergent themes on people's perceptions on relationships between housing or environmental factors and malaria transmission. RESULTS The entomological surveys showed statistically higher indoor densities of the malaria vectors (Anopheles arabiensis and Anopheles funestus) in houses with mud walls compared to plastered or brick walls, open eaves compared to closed eaves and unscreened windows compared to screened windows. Most respondents reported that their houses allowed mosquito entry, at least partially. Participants were aware that house structure and environmental characteristics influenced indoor mosquito densities and consequently malaria transmission. They were concerned about living in poorly-constructed houses with gaps on eaves, walls, windows and doors but were constrained by low income. CONCLUSION In rural south-eastern Tanzania, significant proportions of people still live in houses with open eaves, unscreened windows and gaps on doors. Though they are fully aware of associated mosquito biting and pathogen transmission risks, they are constrained by low-income levels. The study proposes that community-based house improvement initiatives combined with targeted subsidies could lower the financial barriers, improve access to essential construction materials or designs, and significantly accelerate malaria transmission control in these communities.
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Affiliation(s)
- Emmanuel W Kaindoa
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Marceline Finda
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jepchirchir Kiplagat
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Gustav Mkandawile
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania
| | - Anna Nyoni
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania
| | - Maureen Coetzee
- Wits Research Institute for Malaria and Wits/MRC Collaborating Centre for Multidisciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Centre for Emerging Zoonotic & Parasitic Diseases, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Fredros O Okumu
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK
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Madani A, Soleimani-Ahmadi M, Davoodi SH, Sanei-Dehkordi A, Jaberhashemi SA, Zare M, Aghamolaei T. Household knowledge and practices concerning malaria and indoor residual spraying in an endemic area earmarked for malaria elimination in Iran. Parasit Vectors 2017; 10:600. [PMID: 29212553 PMCID: PMC5719751 DOI: 10.1186/s13071-017-2548-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 11/21/2017] [Indexed: 11/27/2022] Open
Abstract
Background Indoor residual spraying of insecticide (IRS) is a key intervention for reducing the burden of malaria infection. Effectiveness and success of this strategy are to a considerable extent dependent on knowledge and practice of the target community regarding the IRS. Iran has entered the malaria elimination phase, and IRS has been considered as the main strategy for malaria vector control. Therefore, this study was conducted to determine the household knowledge and practices about malaria and IRS in Bashagard County, one of the malaria-endemic areas in the southeast of Iran. Methods A community-based cross-sectional survey was conducted among 420 households in Bashagard County. The participants who were selected using a two-stage randomized cluster sampling procedure were subjected to a tested structured questionnaire. During the survey, direct observations were made concerning the use of IRS as well as housing conditions. The data were coded and analysed using SPSS version 19. Results Knowledge levels about malaria as a disease and the mosquito as its vector were high and of equal magnitude (85.5% and 85.4%, respectively), while knowledge levels of IRS were even higher (91.6%). The main source of households’ information about malaria and IRS was primarily community health workers (73.3%). Despite positive perceptions towards IRS only 26.7% of respondents had sprayed their houses which is lower than the WHO targeted coverage of 80%. Respiratory disorders and headache (33.3%), food contamination (24.9%), discolouring of inner house walls (17.7%), difficulty in furniture’s movement (13.8%), and unpleasant odour (10.4%) were the main reasons for IRS refusal. Conclusion There is a discrepancy between knowledge about symptoms and the transmission route of malaria and control practices related to IRS use. Therefore, IRS campaigns accompanied with education for behaviour change should be considered to ensure householders’ participation and cooperation in the IRS programme. Moreover, continuous evaluation and monitoring of IRS as well as conducting more surveys on knowledge, attitude, and practices are recommended to improve malaria control measures and to identify indicators for effective, successful, and sustainable malaria elimination programme.
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Affiliation(s)
- Abdoulhossain Madani
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Moussa Soleimani-Ahmadi
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. .,Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, P.O. Box: 79145-3838, Bandar Abbas, Iran.
| | - Sayed Hossein Davoodi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Sanei-Dehkordi
- Department of Medical Entomology and Vector Control, Faculty of Health, Hormozgan University of Medical Sciences, P.O. Box: 79145-3838, Bandar Abbas, Iran
| | | | - Mehdi Zare
- Department of Occupational Health Engineering, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Social Determinants in Health Promotion Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Tassew A, Hopkins R, Deressa W. Factors influencing the ownership and utilization of long-lasting insecticidal nets for malaria prevention in Ethiopia. Malar J 2017; 16:262. [PMID: 28668084 PMCID: PMC5493859 DOI: 10.1186/s12936-017-1907-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Accepted: 06/26/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Utilization of long-lasting insecticidal nets (LLINs) is regarded as key malaria prevention and control strategy. However, studies have reported a large gap in terms of both ownership and utilization particularly in the sub-Saharan Africa (SSA). With continual efforts to improve the use of LLIN and to progress malaria elimination, examining the factors influencing the ownership and usage of LLIN is of high importance. Therefore, the current study was conducted to examine the level of ownership and use of LLIN along with identification of associated factors at household level. METHODS A cross-sectional study was conducted in Mirab Abaya District, Southern Ethiopia in June and July 2014. A total of 540 households, with an estimated 2690 members, were selected in four kebeles of the district known to have high incidence of malaria. Trained data collectors interviewed household heads to collect information on the knowledge, ownership and utilization of LLINs, which was complemented by direct observation on the conditions and use of the nets through house-to-house visit. Bivariate and multivariable logistic regression analyses were used to determine factors associated to LLIN use. RESULTS Of 540 households intended to be included in the survey, 507 responded to the study (94.24% response rate), covering the homes of 2759 people. More than 58% of the households had family size >5 (the regional average), and 60.2% of them had at least one child below the age of 5 years. The ownership of at least one LLIN among households surveyed was 89.9%, and using at least one LLIN during the night prior to the survey among net owners was 85.1% (n = 456). Only 36.7% (186) mentioned at least as the mean of correct scores of all participants for 14 possible malaria symptoms and 32.7% (166) knew at least as the mean of correct scores of all participants for possible preventive methods. Over 30% of nets owned by the households were out of use. After controlling for confounding factors, having two or more sleeping places (adjusted odds ratio [aOR] = 2.58, 95% CI 1.17, 5.73), knowledge that LLIN prevents malaria (aOR = 2.51, 95% CI 1.17, 5.37), the presence of hanging bed nets (aOR = 19.24, 95% CI 9.24, 40.07) and walls of the house plastered or painted >12 months ago (aOR = 0.09, 95% CI 0.01, 0.71) were important predictors of LLIN utilization. CONCLUSIONS This study found a higher proportion of LLIN ownership and utilization by households than had previously been found in similar studies in Ethiopia, and in many studies in SSA. However, poor knowledge of the transmission mechanisms and the symptoms of malaria, and vector control measures to prevent malaria were evident. Moderate proportions of nets were found to be out of use or in poor repair. Efforts should be in place to maintain the current rate of utilization of LLIN in the district and improve on the identified gaps in order to support the elimination of malaria.
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Affiliation(s)
- Admasu Tassew
- Ethiopian Institute of Water Resources, Addis Ababa University, Akaki Campus, P. O. Box 150461, Addis Ababa, Ethiopia. .,Department of Biology, Arba Minch University, Arba Minch, Ethiopia.
| | - Richard Hopkins
- Natural Resources Institute, University of Greenwich, Chatham Maritime, UK
| | - Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Tumwine JK. Infectious diseases and chronic care in Africa. Afr Health Sci 2015; 15:v-vii. [PMID: 26124825 DOI: 10.4314/ahs.v15i2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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