Knowledge, awareness and practices of malaria in Western Area Rural District, Sierra Leone: a household-based cross-sectional survey in the middle of National Malaria Strategic Plan (2016-2020)

Abstract

Background The malaria epidemic is high in Sierra Leone, and the implementation of the National Malaria Strategic Plan (2016-2020) has reached its middle stage. In order to guide the interventions more specifically in future, a household-based cross-sectional survey was conducted to understand the public perception of knowledge, attitudes and practices of malaria and its control.Methods Three communities (Grafton, Jui and Kossoh) in Western Area Rural District within close proximity to Sierra Leone’s capital city of Freetown were included. Households were randomly selected and interviewed with a structural questionnaire covering malaria infection, diagnosis, treatment and prevention, as well as the knowledge of malaria prevention, in collaboration with the National Malaria Control Program of the Ministry of Health and Sanitation, Sierra Leone. Results A total of 262 qualified questionnaires were included. The average cost for meals per day is around 30000 Leones in each household. The awareness rate of having heard of malaria is 98.1% (257/262) and knowing mosquito biting as its main route of transmission is 86.6% (227/262) respectively. And 80.9% (212/262) of the respondents sought health advice or treatment for the illness, and similar percentage of them could be tested for malaria, mostly through RDTs. A great demand of long-lasting insecticidal nets (72.1%) was raised to fulfill the high shortage (61.8%, 162/262) in households, and of them there were 66 families having children under five years old.Conclusion Malaria burden is still high. Although public awareness of malaria prevention sounds well in this survey, the fact that the coverage of supplies and the use of preventive measures against malaria is low in households within the three communities. It is suggested that an advanced campaign should be carried out to scale up not only the knowledge on malaria but also the actual coverage and usage of malaria prevention measures, contributing to the achievements of planned objectives.