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

Abstract

Background: Despite rapid upscale of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), malaria remains a major source of morbidity and mortality in Zambia. Uptake and utilization of these and novel interventions are often affected by knowledge, attitudes and practices (KAP) amongst persons living in malariaendemic areas. The aims of this study were to assess malaria KAP of primary caregivers and explore trends in relation to ITN use, IRS acceptance and mosquito density in two endemic communities in Luangwa and Nyimba districts, Zambia. Methods: A cohort of 75 primary caregivers were assessed using a cross-sectional, forced-choice malaria KAP survey on ITN use, IRS acceptance and initial perception of a novel spatial repellent (SR) product under investigation. Entomological sampling was performed in participant homes using CDC Miniature Light Traps to relate indoor mosquito density with participant responses. Results: Ninety-nine percent of participants cited bites of infected mosquitoes as the route of malaria transmission although other routes were also reported including drinking dirty water (64%) and eating contaminated food (63%). All caregivers agreed that malaria was a life-threatening disease with the majority of caregivers having received malaria information from health centers (86%) and community health workers (51%). Cumulatively, self-reported mosquito net use was 67%. Respondents reportedly liked the SR prototype product but improvements on color, shape and size were suggested. Overall, 398 mosquitoes were captured from light-trap collections, including 49 anophelines and 349 culicines. Insecticide treated nets use was higher in households from which at least one mosquito was captured. Conclusions: The current study identified misconceptions in malaria transmission among primary caregivers indicating remaining knowledge gaps in educational campaigns. Participant responses also indicated a misalignment between a low perception of IRS efficacy and high stated acceptance of IRS, which should be further examined to better understand uptake and sustainability of other vector control strategies. While ITNs were found to be used in study households, misperceptions between presence of mosquitoes and bite protection practices did exist. This study highlights the importance of knowledge attitudes and practice surveys, with integration of entomological sampling, to better guide malaria vector control product development, strategy acceptance and compliance within endemic communities.

Knowledge, Attitude, and Practices (KAP) of Human Populations towards Malaria Control in Four Ecoepidemiological Settings in Cameroon

“…Concerning the use of interpersonal conversation in Bertoua and Kaélé, it is likely that the frequent shortage of electric power in these cities at the time of the study may have promoted this communication means. Studies in South Africa and Zambia indicated that health facilities could also serve as a primary source of information on malaria [ 8 , 31 ]; however, just few participants went to hospitals to look for information.…”

“…In addition, mortality in healthcare facilities decreased from 25% in 2013 to 14.6% in 2018 [5]. However, despite the increased scale-up of ITNs, residual malaria transmission remains a challenge in most epidemiological settings with high malaria incidence [8][9][10]. Several factors could be responsible for the subperformance of current control interventions.…”

Preventive Measures Against The Vectors Of Malaria In Akanda, Southwest Gabon: Knowledge, Attitudes, Practices, And Beliefs

“…We found that more than 80% of the respondents were aware that the use of ITNs could prevent malaria. This observation has been made by N'dri et al (2020) and Jumbam et al (2020). However, only The respondents reluctance to sleep under ITNs was because it impaired breathing and generated heat.…”

“…Also, most respondents allowed children and adults to sleep under ITNs and this practice has been observed elsewhere by different authors (Owusu et al, 2018 ;Jumbam et al, 2020).…”

Efficacy of a Spatial Repellent for Control of Aedes-Borne Virus Transmission: A Cluster Randomized Trial in Iquitos, Peru

“…15 Together, these results highlight the potential for SRs to reduce a variety of vector-borne diseases, augment existing public health efforts and be an effective component of vector control intervention strategies. To help guide implementation and programmatic scale-up, additional assessments, which have already begun, [26][27][28][29] are needed.…”