Abstract
Background: Understanding area-specific knowledge, attitudes, practices and demographic risk factors towards malaria is becoming critical for designing appropriate awareness and control strategies. Methods: A cohort of respondents from 243 randomly selected households across 3 villages in eastern Tanzania was assessed using a standard questionnaire and direct observation.Results: Fifty-three percent of respondents cited Anopheles mosquitoes that were responsible for transmitting malaria, and 85% of those explicitly cited female Anopheles mosquitoes. The rest (47%) knew that malaria is transmitted by a mosquito but could not name it. Commonly cited mosquito breeding sites were water bodies (75%) and rubbish (24%). Majority (61%) knew that the under-fives were most vulnerable to malaria. ITNs were mostly (64%) cited as a means of malaria control. Commonly cited malaria mosquito entry routes were windows (46%), eave opening (10%) and opening on the walls (4%). Majority (70%) confirmed malaria at the health facility. The rest (30%) relied on symptoms. Majority (96%) preferred modern antimalarials. Seventy-nine percent of the respondents owned at least one ITN. Cooking was done predominantly (77%) outdoors, finished cooking and went to bed after 20:00h. Most (58%) respondents still attended night-time outdoor communal gatherings without malaria protection. Conclusions: The current study indicate that majority of participants were aware that Anopheles mosquitoes were responsible for transmitting malaria, they bred in water, under-five children were most vulnerable to malaria, and ITNs constituted the most deployed control measure. Most respondents preferred confirming malaria at the health facility and treatment with modern antimalarials. Yet, the rate of self-diagnosis and self-medication, as well as inappropriate use of bednets requires great improvement. Demographic risk factors for early- and/or outdoor-transmission included night-time outdoor cooking and attending communal gatherings without malaria protection. The findings warrant a subsequent study to show a causal link between night-time outdoor activities, vector biting patterns and malaria prevalence.
Born to sweet delight: Using natural models of malaria protection to understand and neutralize P. falciparum pathogenesis
