Abstract
BackgroundLocal understandings of malaria and use of preventive measures-are critical factors in sustained control of malaria. This study assessed caretakers’ knowledge on malaria, use of Long Lasting Insecticide Treated Nets (LLINs) and care-seeking behavior for their children’s illness in different malaria transmission settings of Ethiopia.MethodsData were collected from 709 caretakers of children of 2–9 years of age during in 2016. A standard questionnaire was used to assess caretakers’ perceptions of malaria, use of LLIN and care seeking behavior for febrile illness of children aged 2–9 years.ResultsThe caretakers recognized malaria mostly by chills (70.4%, 499/709), fever (45.7%, 324/709) and headache (39.8%, 282/709). Overall, only 66.4% (471) of the caretakers knew that mosquito bite caused malaria and that it was quite heterogeneous by localities (ranging from 26.1% to 89.4%) and altitude (p < 0.05). Majority, 72.2% (512), of the caretakers knew that sleeping under LLIN could prevent malaria. Overall knowledge on malaria (mean = 51.2%) was very low with significant variations by localities, altitude and levels of malaria transmission, being low in high altitude and low in transmission areas (p < 0.05). Four hundred ninety-one (69.3%, 491/709) of the children slept under LLIN in the previous night. Of malaria related knowledge items, only knowledge of LLIN was associated with net use; non-use of LLN was higher among caretakers who did not know the role of LLIN (AOR = 0.47, 95%CI: 0.28–0.77, p = 0.003). Of course, attributing causation of malaria to stagnant water discouraged use of net (p = 0.021). Of febrile children (n = 122), only 50 (41.0%) sought care with only 17 (34.0%) seeking the care promptly. There was no significant link between knowledge of malaria and care seeking behavior (p > 0.05). However, knowledge of malaria had some level of influence on treatment source preference where caretakers with greater knowledge preferred pharmacy as source of care.ConclusionsThe findings demonstrated that caretakers’ understanding of malaria was unsatisfactory with marked heterogeneity by localities. The present evidence suggests that knowledge is not sufficient enough to drive LLIN use and care seeking. Yet, context-specific health education interventions are important besides ensuring access to necessary preventive tools.
Highlights
Local understandings of malaria and use of preventive measures-are critical factors in sustained control of malaria
This study revealed that local understanding of malaria was unsatisfactory and very limited in some localities with arrays of misconceptions on causalities and prevention strategies
The evidence in this study depicted that only knowledge of the benefits of Long Lasting Insecticidal Treated Net (LLIN) positively mediated use of LLIN
Summary
Local understandings of malaria and use of preventive measures-are critical factors in sustained control of malaria. Malaria is one of the oldest mosquito-borne diseases [1]. It is characterized by several clinical manifestations such as sensation of cold, fever, chills, headaches, nausea and vomiting, sweating, joint pain, prostration, and general malaise [2,3,4]. In 2015, an estimated 214 million cases of malaria were recorded globally. Through effective community based health service delivery approaches such as Health Extension Program (HEP) and organized community networks called Health Development Army (HDA) volunteers combined with effective case management, Ethiopia has made a significant progress in reduction of malaria burden [7,8,9,10,11,12,13].
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