Malaria awareness of adults in high, moderate and low transmission settings: A cross-sectional study in rural East Nusa Tenggara Province, Indonesia
AbstractIntroductionThe Indonesian roadmap to malaria elimination in 2009 indicated that the country is progressing towards achieve malaria elimination by 2030. Currently, most of the districts in the western part of Indonesia have eliminated malaria, however, none of the districts in East Nusa Tenggara Province (ENTP) have met set targets. This study aims to investigate the status of malaria awareness of rural adults in the ENTP.MethodsA cross-sectional study was conducted between October and December 2019. Fourteen hundred and ninety-five participants from high, moderate, and low malaria endemic settings (MES) in ENTP were interviewed using a semi-structure questionnaire. A malaria awareness index was developed based on ten questions. Chi-square test was applied to investigate the significance of associations of malaria awareness with the three malaria endemic settings.ResultsParticipants were between 18 and 89 years old, 51.4% were female and 45.5% had completed primary education. Malaria awareness index was 48.8% with the highest in low MES 64.8%, followed by the moderate MES 44.4% and the high MES 37.2% (p<0.001). Of total participants, 81.3% were aware that malaria could be prevented and 75.1% knew at least one prevention measure. Overall, the awareness of fever as the main symptom of malaria, seeking treatment within 24 hours when suffering with malaria, and mosquito bites as the transmission mode of malaria was poor, 37.9%, 46.0%, and 59.1% respectively. The poor level of awareness was statistically significantly different amongst three MES, the level of awareness was the lowest in the high endemic setting.ConclusionMalaria awareness of rural adults needs to be improved to address Indonesia’s national action plan. Results indicate public health programs at a local government level should incorporate the malaria awareness index in their key strategic intervention packages to address local malaria awareness.