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Malaria Journal

, 15:516

First Online: 21 October 2016Received: 15 July 2016Accepted: 06 October 2016DOI: 10.1186-s12936-016-1557-2

Cite this article as: Ovadje, L. & Nriagu, J. Malar J 2016 15: 516. doi:10.1186-s12936-016-1557-2


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.

KeywordsMalaria control Insecticide-treated net Malaria knowledge Behaviour change communication Nigeria Misperceptions AbbreviationsACTartemisinin combination therapy

ANCantenatal care

ANOVAanalysis of variance

BCCbehaviour change communication

EPIexpanded programme on immunization

IRBinstitutional review board

ITNinsecticide-treated net

KAPknowledge, attitudes and practice

LGAlocal government area

MANOVAmultivariate analysis of variance

PMVpatent medicine vendor

TKItotal knowledge index

WHOWorld Health Organization

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Autor: Lauretta Ovadje - Jerome Nriagu


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