Multi-dimensional knowledge of malaria among Nigerian caregivers: implications for insecticide-treated net use by children

Abstract

BackgroundPoor malaria knowledge can negatively impact malaria control programmes. This study evaluates knowledge distribution in the domains of causation, transmission, vulnerability, symptoms, and treatment of malaria. It assesses the association between a caregiver’s knowledge about malaria and ownership and use of insecticide-treated nets (ITNs) by children.MethodsSome 1939 caregivers of young children were recruited through a school-based survey in two Nigerian states. A 20-item, multi-dimensional survey instrument was developed and used to rank each caregiver’s knowledge in five dimensions (cause, transmission, vulnerability, symptoms, treatment of malaria). Scores for each domain were used to create an aggregate knowledge score for each caregiver. The outcome measures were ITN ownership, and ITN use the night and week before the study. Regression models were used to evaluate the relationship between caregiver’s knowledge (individual domains and aggregate score) and ownership and use of ITN after controlling for likely confounders.ResultsThe main predictor of ITN use was ITN ownership (r = 0.653; p < 0.001); however, ownership only explains 43 % of variance in net use. Total knowledge index for the study population was significantly associated with both ITN ownership (r = 0.122; p = 0.001) and use (r = 0.095; p = 0.014). The spectrum of caregiver’s knowledge of malaria and its causes captured in the various domains was, however, found to be poor. Fifty percent of the respondents knew that malaria is transmitted by female mosquitoes and 65 % still believe that too much exposure to the sun is a risk factor for malaria. Knowledge of populations most vulnerable to malaria (83 %) and knowledge of malaria transmission (32 %) were the domains with the highest and lowest average correct answers.ConclusionsThere is a need to improve ITN coverage in Nigeria as ITN ownership was associated with ITN use. Additionally, treating knowledge as a multi-dimensional phenomenon revealed that a lot of misperceptions about malaria still exist. Distribution of ITNs through the public/private sector may need to be augmented with tailored behavioural change communication to dispel myths and improve the multi-dimensional knowledge of malaria in the local population.

Effectiveness of the school-based social and behavior change communication (SBCC) interventions on insecticide-treated nets utilization among primary school children in rural Ethiopia: A quasi-experimental design

“…With behavior-driven factors; the current study identified knowledge, family supports, and self-efficacy as factors influencing the use of ITNs among school children which is consistent with that of previous studies (22). (37).…”

“…Access to more than one ITN per two persons in the household independently predicted the use of ITN in this study. A similar finding was reported from a previous school-based study in that ownership was found as the main predictor of ITN use (37). This is in fact; access alone can't guarantee the ITN of use among school children.…”

“…In the previous study; the total knowledge index was significantly associated with both ITN ownership and its use. However; the study reported varying levels of influence for different domains of knowledge (37). In short; the finding implies; intervention targeting comprehensive knowledge would produce effective behavior change outcomes regarding malaria prevention in schools.…”

“…The current study measured two outcomes of interest in the effects of the interventions. items were used (37). For each item, the correct answer was assigned (1=Yes) and an incorrect answer as (0=No).…”

Malaria control in rural Malawi: implementing peer health education for behaviour change

“…Despite the effectiveness of these interventions, the burden of malaria in poor, rural African communities remains high [ 2 ]. A combination of poor health systems, limited access to malaria prevention, diagnosis and treatment services, poverty, and low levels of education, hinder efforts to reduce malaria in most rural African communities [ 3 , 4 ].…”