Knowledge, attitudes and practices related to malaria: The case of community health workers in Leona, Sakal district, Senegal

Abstract

Introduction Community management of malaria reduces the problem of access to care for remote and/or landlocked populations. In the Leona area, since 2010, the Millennium Villages Project has put in place a community-based mechanism integrating mobile technology for overall household coverage. The objective of the study was to identify gaps in knowledge, attitudes and practices about malaria among community health workers (CHWs). Method This was a descriptive and analytical cross-sectional study conducted from March 21 to April 15, 2016. It involved a comprehensive sampling of 51 CHWs, and 2,023 cases of fever registered in the records from January 1 to December 31, 2015. The data was collected using three media: an observation grid, a questionnaire and a observation grid. The questionnaire served as a basis for individual interviews focusing on the level of knowledge of signs, diagnostic means, and simple malaria treatment modalities. The observation grid made it possible to assess the availability of the material and the equipment of the agent, as well as the mastery of the rapid screening test, the management of malaria (follow-up of the flow chart, therapeutic management) and register filling. The reference parameters were the guidelines of the National Malaria Control Program (NMCP). The data was entered and analyzed with the Epi-info 3.5.3 software. Results The 51 CHWs included two categories: home care providers were 12 (23.5%) and community relays 39 (76.5%). The sex ratio was 0.2. The age ranged from 17 to 47, with an average of 29.4 (±8.3) years. Of the CHWs, 13.7% had a good level of knowledge about malaria; and 80.4% mastered the rapid screening test (RST) technique. A total of 2023 patients had been identified with 89 (4.4%) cases of fever, of which 80 (89.8%) had RST. Out of 80 RSTs, the number of errors was 3 (3.75%). All confirmed cases were treated according to the NMCP guidelines. The filling of the registers was exhaustive for 93.8% of the CHWs. The level of knowledge of CHWs was statistically higher among those aged 25 and over (P = 0.029), and home care providers (P = 0.005). The correct filling of the registers was more common among the educated (P = 0.0005), trained (P = 0.001), supervised (0.0001), and the Relay category (P = 0.0002). Conclusion The CHWs can respect the directives of the NMCP. For this, they must be supported by regular retraining and supervision. This would allow better preventive and curative coverage of malaria for remote and isolated populations.