Malaria knowledge and bed net use in three transmission settings in southern Africa

• Published in: Malaria Journal
• Main Authors: Mufaro Kanyangarara, Harry Hamapumbu, Edmore Mamini, James Lupiya, Jennifer C. Stevenson, Sungano Mharakurwa, Mike Chaponda, Philip E. Thuma, Lovemore Gwanzura, Shungu Munyati, Modest Mulenga, Douglas E. Norris, William J. Moss, For the Southern Africa International Centers of Excellence for Malaria Research
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2018
• Subjects: Insecticide-treated nets; Local knowledge; Malaria prevention and control; Zambia; Zimbabwe; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-018-2178-8; https://doaj.org/article/eed39ce180bb4f2087714ec14bba9ef8

Abstract Background Insecticide-treated nets (ITNs) reduce malaria morbidity and mortality in endemic areas. Despite increasing availability, the use of ITNs remains limited in some settings. Poor malaria knowledge is a barrier to the widespread use of ITNs. The goal of this study was to assess the levels of malaria knowledge and evaluate factors associated with bed net use among individuals residing in three regions of southern Africa with different levels of malaria transmission and control. Methods A cross-sectional study was conducted on a sample of 7535 residents recruited from 2066 households in Mutasa District, Zimbabwe (seasonal malaria transmission), Choma District, Zambia (low transmission) and Nchelenge District, Zambia (high transmission), between March 2012 and March 2017. A standardized questionnaire was used to collect data on demographics, malaria-related knowledge and use of preventive measures. Multivariate logistic regression analyses were used to assess determinants of bed net use. Results Most of the 3836 adult participants correctly linked mosquito bites to malaria (85.0%), mentioned at least one malaria symptom (95.5%) and knew of the benefit of sleeping under an ITN. Bed net ownership and use were highest in Choma and Nchelenge Districts and lowest in Mutasa District. In multivariate analyses, knowledge of ITNs was associated with a 30–40% increased likelihood of bed net use after adjusting for potential confounders across all sites. Other factors significantly associated with bed net use were age, household size and socioeconomic status, although the direction, strength and size of association varied by study site. Importantly, participants aged 5–14 years had reduced odds of sleeping under a bed net compared to children younger than 5 years. Conclusion Relevant knowledge of ITNs translated into the expected preventive behaviour of sleeping under a bed net, underscoring the need for continued health messaging on malaria prevention. The implementation and delivery of malaria control and ...