Knowledge, attitudes and practices regarding malaria prevention and control in communities in the Eastern Region, Ghana, 2020

PLOS ONE RESEARCH ARTICLE Knowledge, attitudes and practices regarding malaria prevention and control in communities in the Eastern Region, Ghana, 2020 Aquel Rene Lopez1, Charles Addoquaye Brown ID2* 1 Tetteh Quarshie Memorial Hospital, Mampong, Ghana, 2 Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle Bu, Accra, Ghana * a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 Abstract Background OPEN ACCESS Citation: Lopez AR, Brown CA (2023) Knowledge, attitudes and practices regarding malaria prevention and control in communities in the Eastern Region, Ghana, 2020. PLoS ONE 18(8): e0290822. https://doi.org/10.1371/journal. pone.0290822 Editor: Enoch Aninagyei, University of Health and Allied Sciences, GHANA Received: February 11, 2023 Accepted: August 16, 2023 Published: August 30, 2023 Copyright: © 2023 Lopez, Brown. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the manuscript and its Supporting information files. Funding: The author(s) received no specific funding for this work. Competing interests: The authors have declared that no competing interests exist. In sub-Saharan Africa countries including Ghana, the malaria burden remains unacceptably high and still a serious health challenge. Evaluating a community’s level of knowledge, attitude, and practice (KAP) regarding malaria is essential to enabling appropriate preventive and control measures. This study aimed to evaluate knowledge of malaria, attitudes toward the disease, and adoption of control and prevention practices in some communities across the Eastern Region of Ghana. Methods A cross-sectional based study was carried out in 13 communities across 8 districts from January -June, 2020. Complete data on socio-demographic characteristics and KAP were obtained from 316 randomly selected household respondents by a structured pre-tested questionnaire. Associations between KAP scores and socio-demographic profiles were tested by Chi-square and binary logistic regression. Data analysis was done with SPSS version 26.0. Results Most respondents (85.4%) had good knowledge score about malaria. Preferred choice of treatment seeking place (50.6%) was the health center/clinic. All respondents indicated they would seek treatment within 24 hours. Mosquito coils were the preferred choice (58.9%) against mosquito bites. Majority of households (58.5%) had no bed nets and bed net usage was poor (10.1%). Nearly half of the respondents (49.4%) had a positive attitude toward malaria and 40.5% showed good practices. Chi-square analysis showed significant associations for gender and attitude scores (p = 0.033), and educational status and practice scores (p = 0.023). Binary logistic regression analysis showed that 51–60 year-olds were less likely to have good knowledge (OR = 0.20, p = 0.04) than 15–20 year-olds. Respondents with PLOS ONE | https://doi.org/10.1371/journal.pone.0290822 August 30, 2023 1 / 17 PLOS ONE Knowledge, attitudes and practices regarding malaria prevention and control in the Eastern Region, Ghana complete basic schooling were less likely to have good knowledge (OR = 0.33, p = 0.04) than those with no formal schooling. A positive attitude was less likely in men (OR = 0.61, p = 0.04). Good malaria prevention practice was lower (OR = 0.30, p = 0.01) in participants with incomplete basic school education compared to those with no formal schooling. Conclusion Overall scores for respondents’ knowledge, though good, was not reflected in attitudes and levels of practice regarding malaria control and prevention. Behavioral change communication, preferably on radio, should be aimed at attitudes and practice toward the disease. Introduction In sub-Saharan Africa, the malaria burden remains unacceptably high and still a serious health challenge [1]. The West African sub-region, due to its current high rates of malaria infections and fatalities, is a hotspot for the disease’s transmission. The sub-region accounts for about half of the malaria global burden [1, 2]. Ghana is among the countries in West Africa with the highest burden of malaria [3]. Ghana has a hyperendemic malaria problem, thus every region is susceptible to infection [4, 5]. The most vulnerable populations are children under 5 years and pregnant women, with malaria accounting for 40.0% of all outpatient attendance [6]. One of the seven work packages created by the WHO Strategic Advisory Group on Malaria Eradication (SAGme) is community engagement for the elimination and eradication of malaria [7]. Thus, the necessity of inclusive and cooperative efforts to eradicate malaria and the significance of maintaining the target community at the forefront of the fight against the disease cannot be overstated. The willingness of each community member to participate and act is greatly influenced by their attitudes toward the disease and the use of any existing control measures if a malaria control program is to succeed in reducing both morbidity and mortality in that community [8]. These attitudes are influenced by their level of knowledge, understanding, and perception [9, 10]. For example, decisions likely to be taken when putative malaria symptoms set in such as, whether to just stay at home, use herbal treatment, buy over-thecounter drugs for self -medication, or go to a health facility [9, 10] may affect treatment outcomes. “Fever”, which is synonymous with malaria in many settings, unfortunately is present in other tropical diseases common in malaria-endemic areas [11]. It thus is important that individuals experiencing a fever seek medical attention as soon as possible to rule out malaria or other possible causes of their illness [11]. Any choice that ultimately results in delayed diagnosis and treatment, particularly in children, may have fatal consequences [12, 13]. Knowledge, attitudes, and practices (KAP) surveys are frequently used tools that can gather crucial data to inform the design of malaria control and prevention activities and interventions, ensuring community participation, acceptance, and adherence [14, 15]. Malaria KAP surveys have been conducted in many African countries including Cape Verde [16], Cameroon [17, 18], Ethiopia [19–22], Nigeria [23, 24] and Senegal [25]. Similar studies have also been conducted in some regions in Ghana [26–29]. However, to our knowledge, there is a scarcity of data on malaria KAP in the Eastern Region of Ghana. The current study therefore aimed to evaluate knowledge of malaria, attitudes toward the disease, adoption of control and prevention practices, and care-seeking behaviors in communities across the Eastern Region of Ghana. The study also investigat (...truncated)