Abstract
BackgroundThe potential contribution of knowledge, attitudes and practices (KAP) studies to malaria research and control has not received much attention in most southern African countries. This study investigated the local communities' understanding of malaria transmission, recognition of signs and symptoms, perceptions of cause, treatment-seeking patterns, preventive measures and practices in order to inform the country's proposed malaria elimination programme in Swaziland.MethodsA descriptive cross-sectional survey was undertaken in four Lubombo Spatial Development Initiative (LSDI) sentinel sites in Swaziland. These sentinel sites share borders with Mozambique. A structured questionnaire was administered to 320 randomly selected households. Only one adult person was interviewed per household. The interviewees were the heads of households and in the absence of the heads of households responsible adults above 18 years were interviewed.ResultsA substantial number of research participants showed reasonable knowledge of malaria, including correct association between malaria and mosquito bites, its potential fatal consequences and correct treatment practices. Almost 90% (n = 320) of the respondents stated that they would seek treatment within 24 hours of onset of malaria symptoms, with health facilities as their first treatment option. Most people (78%) perceived clinics and vector control practices as central to treating and preventing malaria disease. Indoor residual spraying (IRS) coverage and bed net ownership were 87.2% and 38.8%, respectively. IRS coverage was in agreement with the World Health Organization's (WHO) recommendation of more than 80% within the targeted communities.ConclusionDespite fair knowledge of malaria in Swaziland, there is a need for improving the availability of information through the preferred community channels, such as tinkhundlas (districts), as well as professional health routes. This recommendation emerges along with the documented evidence suggesting that as the level transmission and disease decreases so does the perception about the importance of malaria control activities. Finally, given the relatively moderate ownership of bed net there is a need for future studies to evaluate the distribution of insecticide-treated nets (ITNs) compared with IRS.
Highlights
The potential contribution of knowledge, attitudes and practices (KAP) studies to malaria research and control has not received much attention in most southern African countries
MwFiiagtphuionreftSh1we aLzuilbaondmsbhoorweigniog nTinkundlas where study sites are located and the insert shows the position of the country Map of Swaziland showing Tinkundlas where study sites are located and the insert shows the position of the country within the Lubombo region
There is a need for improving the availability of information through the preferred community channels such as tinkhundlas as well as professional health routes such Community Health Workers (CHWs) and Rural Health Motivators (RHMs)
Summary
The potential contribution of knowledge, attitudes and practices (KAP) studies to malaria research and control has not received much attention in most southern African countries. This study investigated the local communities' understanding of malaria transmission, recognition of signs and symptoms, perceptions of cause, treatment-seeking patterns, preventive measures and practices in order to inform the country's proposed malaria elimination programme in Swaziland. Except for southern Africa, many countries in the continent do not have successful malaria control programmes due to among others the magnitude of the problem compounded by lack of adequate health infrastructure, as well as financial and human resources [2]. In most southern African countries, malaria has been greatly reduced through the use of indoor residual spraying complemented by effective case management [2]. The Southern African Development Community (SADC) is one of the few regions in Africa with the potential to eliminate malaria [6]. In more than 50 years of malaria control in Swaziland no published survey of the community knowledge, attitudes and practices has been conducted
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