Perception of malaria risk and use of bed nets in Chad ABSTRACTThe use of Long Lasting Insecticidal-treated Nets (LLINs) and the seasonal malaria chemoprevention are efficient strategies in the fight against malaria. The objective of this survey is to assess the community knowledge about malaria and LLIN use. A descriptive households' survey has been conducted in Chad using questionnaires targeting the head of households. Data collected were entered in Access 2007, cleaned and validated during a workshop held in N'Djamena. Of the 2,000 people targeted, 1,388 (69.4%) responses satisfied all the criteria. 80.6% of the respondents declared owning a LLIN but only 37.6% of those state having used it the night prior to the interview. 68.2% of the respondents perceive malaria as dangerous for the F. H. YANDAÏ et al. / Int. J. Biol. Chem. Sci. 10(6): 2646-2654 2647 fetus and the pregnant women. 50.4% of the respondents state sleeping under the LLIN starting at 8 pm. This survey shows that despite being the first cause of out-patient visits in Chad, risks related to malaria are not fully perceived by the population. More than half of the respondents owning a LLIN did not sleep under it the night prior to the survey.

Malaria risk perception and use of bed nets in Chad ABSTRACTThe use of Long Lasting Insecticidal-treated Nets (LLINs) and the seasonal malaria chemoprevention are efficient strategies in the fight against malaria. The objective of this survey is to assess the community knowledge about malaria and LLIN use. A descriptive households' survey has been conducted in Chad using questionnaires targeting the head of households. Data collected were entered in Access 2007, cleaned and validated during a workshop held in N'Djamena. Of the 2,000 people targeted, 1,388 (69.4%) responses satisfied all the criteria. 80.6% of the respondents declared owning a LLIN but only 37.6% of those state F. H. YANDAÏ et al. / Int. J. Biol. Chem. Sci. 11(1): 228-236, 2017 229 having used it the night prior to the interview. 68.2% of the respondents perceive malaria as dangerous for the fetus and the pregnant women. 50.4% of the respondents state sleeping under the LLIN starting at 8 pm. This survey shows that despite being the first cause of out-patient visits in Chad, risks related to malaria are not fully perceived by the population. More than half of the respondents owning a LLIN did not sleep under it the night prior to the survey.

Background: Nomadic populations in Chad are at increased risk of contracting malaria because of their lifestyle. Being highly mobile they are often excluded from disease control programs, and access to preventive measures and treatment is more difficult. Effective malaria control interventions take account of local modes of transmission, patterns of care-seeking behavior and community perceptions of cause and prevention practices. There is currently little information about malaria knowledge and perceptions among nomadic groups in Chad, or their awareness of malaria control interventions and this study sought to address this knowledge gap. Methods: A mixed methods study, including a cross-sectional survey with men and women (n = 78) to determine the level of knowledge and use of malaria prevention strategies among Arabs, Peuls and Dagazada nomadic groups. Three focus group discussions were conducted with women to explore their representation of malaria and knowledge of preventive methods. Key informant interviews were held with leaders of nomadic groups (n = 6) to understand perception of malaria risk among itinerant communities.Results: nomads are aware of the risk of malaria, recognize the symptoms and have local explanations for the disease. Reported use of preventive interventions such as Seasonal Malaria Chemoprophylaxis (SMC) for children and Intermittent Preventive Treatment (IPT) of malaria in pregnancy was very low. However, 42.3% of respondents reported owning at least one LLIN and 60% said they slept under an LLIN the night before the survey. In case of a malaria episode, nomads seek clinicians, informal drug sellers in the street or market for self-medication, or traditional medicine depending on their financial means. Interviews with nomad leaders and discussions with women provide key themes on: (i) social representation of malaria risk and (ii) social representation of malaria and (iii) perspectives on malaria prevention and (iv) malaria treatment practices.Conclusion: The nomadic groups included in this study are aware of risk of malaria and their level of exposure. Local interpretations of the cause of malaria could be addressed through tailored and appropriate health education. Except for LLINs, malaria prevention interventions are not well known or used. Financial barriers lowered access to both mosquito nets and malaria treatment. Reducing the barriers highlighted in this study will improve access to the healthcare system for nomadic groups, and increase the opportunity to create awareness of and improve uptake of SMC and IPT among women and children.