Abstract

Information on malaria prevention practices in households was obtained in a nation-wide knowledge, attitudes, and practices survey in Malawi. Of the 1,531 heads of household questioned, 55% were able to identify mosquitoes as the cause of malaria. Use of any type of malaria prevention method was reported by 52% of respondents. Among users, 47% used commercial products (insecticide, mosquito coils, bednets), and 64% used natural measures (burning leaves, dung, or wood); 11% used both. The most common commercial measure used was mosquito coils (16%) followed by insecticide spray (11%) and bednets (7%). Increasing household income and educational level of the household head were strongly correlated with use of commercial methods to prevent malaria; households with an income ranked moderate or greater were eight times more likely to have used a purchased product. Use of natural measures was correlated with lower income and educational level. Thirty-six percent of respondents reported having heard or seen information on malaria in the previous year. Use of household malaria preventive measures in Malawi is very low and income-dependent. Educational messages are required to improve understanding and use of affordable measures.

PIP:

Information on malaria prevention practices in households was obtained in a nationwide knowledge, attitudes, and practices survey in Malawi. Of the 1531 heads of household questioned, 55% were able to identify mosquitoes as the cause of malaria. Use of any type of malaria prevention method was reported by 52% of respondents. Most were male (80%), 20-49 years of age (80%), had no or primary (grade 1-8) education (91%), were married (82%), and had a very low or low annual household income level (72%). 55% of respondents identified mosquitoes as the cause of malaria. Cold weather (19%) was the second most common response. 24% of the respondents replied that they did not know the cause of malaria. A total of 550 (36%) respondents reported hearing or seeing any information about malaria in the previous 12 months. Overall, 795 (52%) of respondents reported any type of malaria prevention used in the household. Among these users, 372 (47%) used commercial products (insecticide, mosquito coils, bednets), 508 (64%) used natural measures (burning leaves, dung, or wood); and 85 (11%) reported having used both. The most common measure used was mosquito coils (16%) followed by insecticide spray (11%) and bednets (7%). Having used a purchased product for malaria prevention in the household was strongly associated with both an increasing education level of the head of the household (Chi-square for linear trend = 128.8; p 0.001) and an increasing household income level (Chi-square for linear trend = 206.6; p 0.001). Respondents reporting secondary or higher education were approximately eight times more likely to have used a purchased product in the household to prevent malaria than were those who reported primary or no education (Odds Ratio [OR] 8.1). Similarly, those with moderate or high incomes were five times more likely to have ever used a purchased product than those with lower incomes (OR 5.3). Educational messages are required to improve use of affordable household malaria preventive measures.