Willingness to Accept Malaria Mass Drug Administration Using the Theoretical Framework of Acceptability in an Urban Municipality of Ghana: A Cross-Sectional Study

Willingness to Accept Malaria Mass Drug Administration Using the Theoretical Framework of Acceptability in an Urban Municipality of Ghana: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Willingness to Accept Malaria Mass Drug Administration Using the Theoretical Framework of Acceptability in an Urban Municipality of Ghana: A Cross-Sectional Study Perfect Amegah, Hainau Iddrisu, Harriet Affran Bonful This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9192638/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 15 You are reading this latest preprint version Abstract Background Malaria continues to pose a major public health threat in sub-Saharan Africa, with Ghana accounting for 2.5% of all malaria cases in the region. Mass drug administration (MDA) has emerged as a viable intervention for malaria elimination, yet its success largely depends on community acceptance and adherence, particularly when asymptomatic individuals are required to take antimalarial drugs. The study assessed the willingness of adults in the La Dade-Kotopon Municipality (LaDMA) of Ghana to accept Malaria MDA programs, particularly using dihydroartemisinin-piperaquine (DHAP). Methods This study employed a cross-sectional study design involving 421 adults from two communities in LaDMA. Household sampling was used in the selection of participants. A total of 421 households were sampled in the two communities. A structured questionnaire was administered to participants. Acceptability of MDA was assessed using Sekhon et al seven Theoretical Framework of Acceptability (TFA) constructs. Both descriptive and inferential analyses were conducted at an alpha level of 0.05. Results The mean age of the participants was36 years and 57.5% were females. Majority (58.7; 95% CI 54.0–63.0) of the participants in LaDMA found the malaria MDA program acceptable and will be willing to participate in it. The factors associated with acceptability of the malaria MDA were age ( p = 0.001), community ( p = 0.004), level of education (p = 0.033), occupation ( p = .0.003), monthly income ( p = 0.042), religion (p < 0.001), tribe (p < 0.001), cultural permissions (p = 0.022) and community wellbeing (p < 0.001). Individuals aged 50–59 years had 66% lower odds of MDA acceptability compared to those aged 18–29 years (aOR = 0.34, 95% CI: 0.11–0.95, p = 0.040). Those with tertiary education had 72% lower odds of MDA acceptability compared to those with primary education (aOR = 0.28, 95% CI: 0.09–0.86, p = 0.027). Ewes had 68% lower odds of MDA acceptability compared to Gas (aOR = 0.32, 95% CI: 0.12–0.82, p = 0.019) Conclusion Willingness to accept malaria MDA program is moderate. Residents who agreed to participate in MDA programs for purposes of community wellbeing found MDA more acceptable compared to those who disagreed. Emphasizing community-wide benefits may enhance participation in future MDA programs. Acceptability Willingness Malaria MDA LaDMA Figures Figure 1 Introduction Malaria remains a significant global health challenge, particularly in sub-Saharan Africa, where it contributes to elevated rates of morbidity and mortality. According to the World Health Organization, there were an estimated 263 million cases of malaria and 597,000 deaths worldwide in 2023, with approximately 95% of these fatalities occurring in the African Region ( 1 ). Despite the intensified effort in reducing the global malaria burden, a substantial number of individuals at risk in this region continue to lack access to essential services for the prevention, diagnosis, and treatment of the disease ( 1 ). Malaria remains endemic in Ghana contributing about 2.5% to the global prevalence ( 1 ). However, the country has made progress in malaria control over the past decade through key interventions such as distribution of LLINs, indoor residual spraying, improved case management, malaria vaccination programs, and strengthened surveillance systems ( 2 ). Although these efforts have contributed to a decline in malaria prevalence in the country ( 3 ), sustained transmissions in areas that are potential hotspots for asymptomatic transmissions ( 4 ) may require additional interventions such as Mass Drug Administration (MDA). MDA involves the provision of a complete therapeutic course of antimalarial medication to all individuals within a defined population or geographical area, irrespective of the presence of symptoms or infection status, except for those for whom the medication is contraindicated ( 5 ). This intervention typically occurs simultaneously and at repeated intervals ( 5 ). The primary objective of this strategy is to minimize community-level transmission by reducing the human reservoir of the malaria parasite, thereby preventing future infections ( 6 ). Current malaria treatment strategies primarily utilize artemisinin-based combination therapies (ACTs), which are recommended by the World Health Organization (WHO) ( 1 ). One notable ACT is dihydroartemisinin-piperaquine (DHAP), recognized for its high efficacy in eliminating Plasmodium falciparum infections while providing extended prophylactic protection against subsequent infections ( 7 ). The prolonged elimination half-life of piperaquine sustains drug levels in the body, rendering it particularly advantageous for (MDA) programs ( 7 ). In 2020, DHAP was adopted as a second-line antimalarial treatment for uncomplicated malaria in Ghana following a comprehensive review of the country's antimalarial medicines policy ( 8 ). The utilization of (DHAP) in MDA is substantiated by its effectiveness in significantly decreasing the malaria parasite reservoir within a community ( 9 ) By administering DHAP to entire populations, including asymptomatic individuals, MDA can disrupt transmission cycles and contribute to the prevention of new infections. Previous MDA campaigns employing DHAP have yielded positive outcomes, resulting in reductions in both the incidence and prevalence of malaria, thereby underscoring its potential as a crucial component in malaria elimination strategies ( 9 ). Despite the potential benefits of DHAP in MDA, community acceptance is crucial for the success of these interventions. ( 10 ). A systematic review involving 10 countries, 3 regions in Africa revealed that MDA coverage ranged from 75% to 91% per round in the four-week low frequency MDA arm and 84% to 97% per round in the two‐week high frequency MDA arm ( 11 ). Factors such as fear of side effects, a lack of perceived need, and cultural beliefs can influence individuals' decisions to participate in MDA campaigns ( 12 – 16 ). Previous studies in Ghana have also indicated that community perceptions and the willingness to embrace new treatments significantly impact the effectiveness of malaria control programs ( 17 – 19 ). Furthermore, acceptability of health interventions has been reported to be mainly driven by intensified community engagement campaigns constantly adapted to the local context, and a delivery strategy that promotes community ownership and trust ( 20 ). Therefore, understanding these factors is essential for designing effective community engagement strategies that enhance the acceptance and adherence to this intervention. To better understand individual’s perceptions of health interventions, theory-based approaches have increasingly been recommended. The Theoretical Framework of Acceptability (TFA) developed by Sekhon and colleagues defines acceptability as a multi-dimensional construct reflecting individual’s cognitive and emotional responses to an intervention ( 21 ). The framework identifies seven key components that influence intervention acceptability: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy ( 22 ). By examining these dimensions, the framework provides a useful conceptual approach for evaluating how individuals perceive and respond to health interventions ( 22 ). With the shift towards malaria elimination in Ghana and the adoption of malaria MDA as one of the elimination interventions, empirical evidence on population willingness to participate in malaria-specific MDA programs using dihydroartemisinin-piperaquine is a prerequisite for program planning and implementation. While previous studies have examined malaria knowledge, prevention practices, and treatment behaviors in Ghana ( 23 – 25 ), limited research has applied a theory-driven framework to assess the acceptability of malaria MDA interventions, particularly in urban settings. Furthermore, earlier studies on MDA acceptability in Ghana have focused largely on neglected tropical diseases ( 16 , 26 – 28 ).The current study contributes to knowledge on the willingness of adults to accept MDA for malaria elimination and explores factors influencing its acceptability in urban Accra aiming to inform the planning and implementation of malaria MDA programs in Ghana. Methods Study Design and Setting This study employed a cross-sectional study design and was conducted in the La Dade-Kotopon Municipal Assembly (LaDMA), which is one of the 261 Metropolitan, Municipal, and District Assemblies (MMDAs) in Ghana. LaDMA has a population of 140,264 with 48.6% males ( 29 ). Data were collected from October to November 2025. Sample size calculation and sampling procedure The sample size for this study was estimated using the Cochran's formula for sample size determination (Cochran, 1977). A study on implementing population-based mass drug administration for malaria in North east Uganda recorded an average prevalence of 80% across the four rounds of MDA intervention ( 30 ). Using this prevalence, the minimum sample size required for this study was 246. Adjusting for a design effect of 1.5 (a common conservative estimate for public health surveys using cluster sampling), ( 31 ) the sample size was calculated as 369. A 10% non-response rate was considered, bringing the sample size for this study to 406 participants. A step-by-step stratified procedure was used to select the study participants by sampling at the community and household levels. La and Burma Camp communities were purposively selected and divided into smaller zones using natural boundaries like roads or landmarks. These two communities were the most populated communities out of the nine communities in LaDMA and suggested a good representation of the municipality. Number of households in each zone were estimated and samples allocated proportionately across each zone. A random starting point was chosen by tossing a coin then every 5th household was sampled. In each selected household one eligible participant was randomly recruited and interviewed. Eligibility Criteria Individuals who were 18 years old and above and had lived in the selected community for more than 6 months were included in the study. Apparently sick community members were excluded from the study. Data Collection and Analysis A theory-informed questionnaire for assessing the acceptability of healthcare interventions ( 21 ) was adapted. The questionnaires were administered to adults aged 18 years and above residing in the selected communities in LaDMA. Questionnaires were structured to collect information on sociodemographic characteristics of participants as well as their lived experiences with malaria and cultural beliefs. The primary outcome, acceptability of MDA was assessed using the Theoretical Framework of Acceptability (TFA) constructs ( 21 ). The outcome variable, acceptability of MDA was measured using the seven TFA construct of acceptability; perceived effectiveness, affective attitude, intervention coherence, self-efficacy, ethicality, opportunity cost and burden. The seven TFA construct of acceptability were measured on a 5-point Likert scale. ( 21 ). Two research assistants were recruited to collect data using the KoboCollect app after training and pretesting data collection tool at Teshie. Statistical analysis Data was downloaded from KoboCollect tool onto an excel sheet and imported to Stata version 17. Data was cleaned by verifying completeness, accuracy, and consistency. All incomplete responses were deleted. Each variable was appropriately coded for efficient input into statistical software. For this study, an aggregate/mean score of 7–24 equals Unacceptable and an aggregate/mean score of 25–35 equals Acceptable ( Supplementary information ). The dichotomized aggregate/mean score of the TFA constructs was used as the outcome variable. Descriptive statistics of the socio-demographic factors, cultural beliefs and lived Malaria experiences as well as the seven TFA constructs were computed. Bivariate analysis was used to determine the association between the independent variables and the outcome variables. Univariate and multivariate logistic regression was used to further identify the predictors of willingness to accept MDA. For categorical predictors with multiple levels, the overall significance was assessed using Likelihood Ratio (LR) tests, comparing the full model to nested model excluding the variables in question. Finally, model goodness-of-fit was evaluated using Hosmer-Lemeshow test (g = 10). A non-significant p-value (p > 0.05) on the Hosmer-Lemeshow test was used to indicate that the model’s predicted probabilities were well-calibrated with the observed data. Analysis was performed at 95% CI and 0.05 precision level. Results Sociodemographic characteristics of study participants Majority (72.0%, 95% CI: 67.0–76.0) of participants were residents of La. The median (IQR) age of participants was 33 (27–44). More than half (57.5%, 95% CI: 53.0–62.0) of the participants were females. With level of education, participants who attained only primary education formed the majority (34.4%, 95% CI: 30.0–39.0). Nearly 80% (95% CI: 75.0–83.0) of the participants were employed. Majority of the participants (28. 0%, 95% CI: 24.0–33.0) refused disclosure of their monthly income while the least represented group (5.7%, 95% CI: 4.0–8.0) earn 5000 Ghana cedis and above. Christianity was the most represented (72.7%, 95% CI: 68.0–77.0) religion and majority (40.1%, 95% CI: 57.0–67.0) of the participants were of the Ga tribe (Table 1 ). Table 1 Sociodemographic characteristics of study participants in LaDMA Variable/ Characteristic (n = 421) Frequency (n = 421) Percentage (%) Median age, IQR ( 33 , 17 ) Age group (Years) 18–29 159 37.8 30–39 115 27.3 40–49 78 18.5 50–59 46 10.9 60 and above 23 5.5 Community La 303 72.0 Burma Camp 118 28.0 Sex Males 179 42.5 Females 242 57.5 Level of education Primary 145 34.4 Secondary 143 34.0 Tertiary 133 31.6 Occupation Unskilled labor 122 29.0 Skilled trade 115 27.3 Professional 62 14.7 Administrative/Clerical 40 9.5 Service industry 35 8.3 Security service 31 7.4 Pensioner 16 3.8 Employment status Employed 334 79.3 Unemployed 87 20.7 Monthly income Can’t disclose 118 28.0 Below GHS 500 35 8.3 GHS 500–1499 87 20.7 GHS 1500–2999 80 19.0 GHS 3000–4999 77 18.3 GHS 5000 and above 24 5.7 Religion Christianity 306 72.7 Islam 44 10.5 Traditional African religion 25 5.9 Others 30 7.1 None 16 3.8 Tribe Ga 169 40.1 Akan 91 21.6 Ewe 55 13.1 Fante 29 6.9 Others 77 18.3 Lived Malaria Experiences and Cultural Beliefs of Study Participants Majority (80.3%, 95% CI: 76.0–84.0) reported that they have ever been diagnosed with malaria. Regarding cultural permissions to taking medication even when one does not feel sick in the context of MDA, 66.3% (95% CI: 26.0–35.0) of the participants disagreed. However, with participants’ action for community wellbeing by participating in MDA, over 70% (95% CI: 71.0–79.0) of the participants agreed (Table 2 ). Table 2 Lived malaria experiences and cultural beliefs of study participants Variable/ Characteristic (n = 421) Frequency (n = 421) Percentage (%) Previous malaria diagnosis Yes 338 80.3 No 83 19.7 Cultural permissions Strongly disagree 51 12.1 Disagree 228 54.2 No opinion 13 3.1 Agree 94 22.3 Strongly agree 35 8.3 Community wellbeing Strongly disagree 21 5.0 Disagree 62 14.7 No opinion 22 5.2 Agree 164 39.0 Strongly agree 152 36.1 The Seven TFA constructs of MDA Acceptability More than half (53.9%) of the participants reported being comfortable with taking malaria medicine even when they do not feel sick. For perceived effectiveness, 70.8% of the participants agreed that malaria MDA medicine is likely to increase their chances of not being seriously sick with malaria. Majority (74.8%) of the participants reported clear understanding that participating in the malaria MDA reduces their risk of becoming seriously sick with Malaria. A little over seventy percent (71.3%) of participants felt confident adhering to the treatment regimen of the malaria MDA medicine. Nearly two-thirds (65.8%) of participants perceived that it would take them no effort to participate in the Malaria MDA program. Majority (70.6%) of the participants disagreed that the Malaria MDA program will interfere with their other priorities. For ethicality, 73.2% of the participants said the malaria MDA program is fair (Table 3 ). Table 3 Study participants response to The Seven TFA construct Variable/Characteristic (n = 421) Frequency (n = 421) Percentage (%) Affective attitude Very uncomfortable 36 8.5 Uncomfortable 132 31.3 No opinion 26 6.2 Comfortable 199 47.3 Very comfortable 28 6.7 Perceived effectiveness Strongly disagree 12 2.9 Disagree 49 11.6 No opinion 62 14.7 Agree 262 62.2 Strongly agree 36 8.6 Intervention coherence Strongly disagree 6 1.4 Disagree 53 12.6 No opinion 47 11.2 Agree 267 63.4 Strongly agree 48 11.4 Self-efficacy Very unconfident 20 4.5 Unconfident 63 15.0 No opinion 38 9.0 Confident 198 47.0 Very confident 102 24.2 Burden No effort at all 134 31.8 A little effort 143 33.0 No opinion 31 7.34 A lot of effort 96 22.8 Huge effort 17 4.0 Opportunity cost Strongly disagree 53 12.6 Disagree 244 58.0 No opinion 27 6.4 Agree 69 16.4 Strongly agree 28 6.7 Ethicality Very unfair 12 2.9 Unfair 45 10.7 No opinion 56 13.3 Fair 211 50.1 Very fair 97 23.0 Prevalence of Malaria MDA Acceptability in the La Dade-Kotopon Municipality Majority of the participants (58.7%, 95% CI: 54.0–63.0) reported the malaria MDA program acceptable (Fig. 1 ). Bivariate Analysis of Malaria MDA Acceptability and Independent Variables The chi-square analysis showed that participants’ age ( p = 0.001), community resided ( p = 0.004), level of education (p = 0.033), occupation ( p = 0.003), monthly income ( p = 0.042), religion ( p < 0.001), tribe ( p < 0.001), cultural permissions ( p = 0.022) and community wellbeing (p < 0.001) were significantly associated with MDA acceptability. However, variables such as sex of participants, employment status and previous malaria diagnosis were not significantly associated with MDA acceptability ( p > 0.05) (Table 4 ). Table 4 Chi-square test of association of MDA acceptability and independent variables Variable/ Characteristic (n = 421) Unacceptable Acceptable Chi-square value p-value Age group (Years) 18–29 51(32.1) 108(67.9) 18.677 0.001 30–39 43(37.4 72(62.6) 40–49 42(53.9) 36(46.1) 50–59 28(60.9) 18(39.1) 60 and above 10(43.5) 13(56.5) Community Burma Camp 62(52.5) 56(47.5) 8.500 0.004 La 112(37.0) 191(63.0) Sex Males 71(39.7) 108(60.3) 0.356 0.551 Females 103(42.6) 139(57.4) Level of education Primary 56(38.6) 89(61.4) 6.820 0.033 Secondary 51(35.7) 92(64.3) Tertiary 67(50.4) 66(49.6) Occupation Administrative/Clerical 16(40.0) 24(60.0) 19.524 0.003 Pensioners 5(31.3) 11(68.7) Professionals 26(41.9) 36(58.1) Security services 21(67.7) 10(32.3) Service industry 8(22.9) 27(77.1) Skilled trade 56(48.7) 59(51.3) Unskilled labor 42(34.4) 80(65.6) Employment status Employed 142(42.5) 192(57.5) 0.936 0.333 Unemployed 32(36.8) 55(63.2) Monthly income Can’t disclose 58(49.2) 60(50.8) 11.498 0.042 Below GHS 500.00 9(25.7) 26(74.3) GHS 500.00–1499.00 32(36.8) 55(63.2) GHS 1500.00–2999.00 28(35.0) 52(65.0) GHS 3000.00–4999.00 33(42.9) 44(57.1) GHS 5000.00 and above 14(58.3) 10(41.7) Religion Christianity 82(26.8) 224(73.2) 100.249 < 0.001 Islam 31(70.5) 13(29.5) Other religions 61(85.9) 10(14.1) Tribe Akan 35(38.5) 56(61.5) 27.630 < 0.001 Ewe 32(58.2) 23(41.8) Fante 15(51.7) 14(48.3) Ga 48(28.4) 121(71.6) Others 44(57.1) 33(42.9) Previous Malaria Diagnosis No 40(48.2) 43(51.8) 2.008 0.156 Yes 134(39.6) 204(60.4) Cultural permissions Disagree 110(37.7) 182(62.3) 5.261 0.022 Agree 64(49.6) 65(50.4) Community wellbeing Disagree 97(92.4) 8(7.6) 150.351 < 0.001 Agree 77(24.4) 239(75.6) Factors Associated with Malaria MDA Acceptability From the multivariate regression model, age of participants, level of education, religion, tribe, cultural beliefs and community wellbeing were significantly associated with the malaria MDA acceptability. Participants aged 50–59 years had 66% lower odds of the malaria MDA acceptability (aOR = 0.34, 95% CI: 0.11–0.95, p = 0.040) and those aged 60 years and above had 88% lower odds of the malaria MDA acceptability (aOR = 0.12, 95% CI: 0.02–0.78, p = 0.027) compared to those aged 18–29 years. Those with tertiary education were 72% less likely to accept the Malaria MDA compared to those with only primary education (aOR = 0.28, 95% CI = 0.09–0.86, p = 0.027). Muslims were 82% less likely to accept the malaria MDA (aOR = 0.18, 95%CI: 0.07–0.46, p < 0.001) and those belonging to other religions were 90% less likely to accept the malaria MDA (aOR = 0.10, 95% CI: 0.04–0.25, p < 0.001) compared to Christians. Ewes were 68% less likely to accept the malaria MDA compared to Gas (aOR = 0.32, 95% CI: 0.12–0.82, p = 0.019). Participants who agreed that they will participate in malaria MDA programs for their community’s wellbeing were 45.29 times more likely to participate compared to their counterparts (aOR = 46.29, 95% CI: 18.32–116.99, p < 0.001) (Table 5 ). A likelihood ratio test confirmed that age, level of education and tribe were significant predictors of MDA acceptability, x 2 ( 11 ) = 139.95, p = < 0.001, despite some individual categories not reaching significance. The Hosmer-Lemeshow test also indicated that the model was well-calibrated, x 2 ( 8 ) = 14.68, p = 0.0657. Table 5 Univariate and multivariate logistic regression estimates of the predictors of MDA acceptability Variables/ Characteristic(n = 421) cOR (95% CI) p-value aOR (95% CI) p -value Age group (Years) 18–29 Ref 30–39 0.79 (0.48–1.31) 0.361 0.80 (0.37–1.76) 0.581 40–49 0.41 (0.23–0.70) 0.001 0.65 (0.26–1.67) 0.376 50–59 0.30 (0.15–0.60) 0.001 0.34 (0.11–0.95) 0.040* 60 and above 0.61 (0.25–1.49) 0.281 0.12 (0.02–0.78) 0.027* Community La Ref Burma Camp 0.53 (0.34–0.81) 0.004 0.58 (0.30–1.12) 0.110 Level of education Primary Ref Secondary 1.14 (0.70–1.83) 0.604 0.54 (0.24–1.25) 0.154 Tertiary 0.62 (0.38–1.00) 0.049 0.28 (0.09–0.86) 0.027* Occupation Unskilled labor Ref Administrative/Clerical 0.79 (0.38–1.64) 0.524 3.77 (0.88–16.19) 0.074 Pensioners 1.16 (0.38–3.54) 0.801 5.87 (0.64–54.26) 0.119 Professionals 0.73 (0.39–1.36) 0.319 1.25 (0.36–4.30) 0.723 Security services 0.25 (0.11–0.58) 0.001 0.54 (0.13–2.27) 0.397 Service industry 1.77 (0.74–4.24) 0.199 1.15 (0.32–4.13) 0.828 Skilled trade 0.55 (0.33–0.93) 0.026 0.50 (0.22–1.11) 0.089 Monthly income Can’t disclose Ref Below GHS 500.00 2.79 (1.21–6.47) 0.017 1.68 (0.45–6.22) 0.436 GHS 500.00–1499.00 1.66 (0.94–2.93) 0.079 0.77 (0.32–1.83) 0.553 GHS 1500.00–2999.00 1.80 (1.00–3.22) 0.050 1.39 (0.57–3.43) 0.471 GHS 3000.00–4999.00 1.29 (0.72–2.30) 0.389 1.91 (0.74–4.92) 0.181 GHS 5000.00 and above 0.69 (0.28–1.68) 0.414 0.94 (0.24–3.64) 0.933 Religion Christianity Ref Islam 0.15 (0.08–0.31) < 0.001 0.18 (0.07–0.46) < 0.001* Other religions 0.06 (0.03–0.12) < 0.001 0.10 (0.04–0.25) < 0.001* Tribe Ga Ref Akan 0.63 (0.37–1.09) 0.098) 0.75 (0.35–1.63) 0.470 Ewe 0.29 (0.15–0.54) < 0.001 0.32 (0.12–0.82) 0.019* Fante 0.37 (0.17–0.83) 0.015 0.75 (0.22–2.58) 0.650 Others 0.30 (0.17–0.52) < 0.001 0.66 (0.27–1.59) 0.353 Cultural permissions Disagree Ref Agree 0.61 (0.40–0.93) 0.022 0.86 (0.43–1.69) 0.660 Community wellbeing Disagree Ref Agree 37.63 (17.51–80.90) < 0.001 46.29 (18.32–116.99) < 0.001* *Statistically significant Discussion This study reports that the willingness to accept malaria MDA in LaDMA is generally moderate. Most participants demonstrated a favourable emotional disposition, recognized the intervention as coherent, effective, and aligned with their values, and felt capable of participating, suggesting that uptake and adherence could be promising if the intervention is implemented. The relatively low perceived burden and acceptable opportunity costs further support participation. However, the presence of a minority expressing discomfort, concerns regarding burden or cost, or uncertainty indicates that universal uptake cannot be guaranteed; these sub-groups may require additional information, reassurance, or tailored engagement strategies to convert willingness into actual participation. Finding from this study is similar to that of Legendre et al, recent mixed-methods study conducted in the high-malaria burden region of Kedougou, Senegal, utilizing the same seven-construct framework where acceptability was found to be good ( 32 ). Additionally, they identified that a comprehensive understanding of MDA, a strong perception of effectiveness, and acknowledgment of malaria as a significant burden were key facilitators of acceptability. Conversely, the primary barriers identified were concerns regarding side effects and the reluctance to take medication while asymptomatic ( 32 ). In this study, age was found to be associated with willingness to accept malaria MDA. Participants who were 50 years and above had lower odds of accepting MDA. This could be because older adults may find it difficult to adapt to new health interventions. The findings are consistent with the findings from another study which indicates that age can influence health behaviors, with younger individuals often demonstrating greater adaptability to new health strategies ( 33 ). However, it is also essential to acknowledge that older adults may possess distinct health beliefs and needs ( 33 ). Education is correlated with health outcomes, as higher educational attainment is associated with improved health knowledge, increased access to resources, and enhanced health behaviors ( 34 ). Contrary to these conventional assumptions that higher education predicts greater health intervention uptake, individuals with tertiary education in this study were less likely to accept MDA. This may be because individuals with higher educational attainment are likely to scrutinize and question population-wide health interventions. Therefore, interventions should be designed to accommodate varying levels of understanding and to tailor communication strategies accordingly ( 16 ). Income levels varied significantly; however, a substantial portion (28%) chose not to disclose their income. This socio-economic diversity suggests that any mass drug administration (MDA) program in the municipality must effectively reach a wide range of livelihoods, from low-income informal laborers to higher-income professionals. Consequently, the implementation of MDA cannot assume uniform participation based solely on economic or occupational status. Individuals employed in unskilled or informal sectors, particularly those with low or unstable incomes, may exhibit a higher risk of non-participation due to factors such as mobility, absence during distribution times, or limited access to information. On the other hand, higher-income or formally employed individuals may also choose to opt out, especially if they perceive the risk of malaria as low or harbor mistrust toward the intervention. This highlights the necessity for tailored and adaptable outreach and distribution strategies. Prior research indicates that non-participation in MDA is strongly linked to occupation such as livestock breeding or other mobility-related trades, and lower income ( 35 ). The high prior malaria prevalence may increase perceived need for MDA, which often correlates with acceptability. However, concerns about negative effects and mixed support for cultural/religious permission suggest that uptake may not be uniform and thus, religious and ethnic identity may influence acceptability and adherence. Therefore, any MDA program in this context must not only communicate benefits but also actively address religious and cultural concerns to maximize coverage and compliance. In a systematic review of MDA for neglected tropical diseases, it was observed that religious and traditional beliefs can impede uptake, particularly in communities that rely on faith-based healing or interpret illness through non-biomedical perspectives. ( 36 ). In the context of malaria-specific MDA and test-and-treat initiatives, studies have identified refusals associated with religious objections, mistrust of healthcare workers, concerns regarding blood draws or medications, and the belief that preventive treatment is unnecessary for asymptomatic individuals ( 37 ). In contrast, acceptance of MDA tends to be higher among individuals and communities that recognize malaria as a significant burden, understand the rationale behind MDA, and view it as beneficial to community wellbeing ( 32 ). Overall, understanding these nuances is essential for the design of effective and inclusive MDA initiatives. A few limitations were identified in this study. This study relied on self-reported data and this may have introduced social desirability bias, potentially leading to overestimation of acceptability toward mass drug administration. Additionally, the findings of this study may only be generalizable to communities similar to the study area. Conclusion More than half of the participants (~ 59%) indicated a willingness to accept MDA, reflecting a moderate level of acceptability within the community. Key enabling factors included older age, higher educational attainment, skilled occupations, and recognition of the communal benefits of MDA. In contrast, younger age groups, lower educational levels, unskilled labour, and minority religious affiliations were associated with lower acceptability. While a significant number of adults are willing to participate in malaria MDA programs, achieving the community level high coverage require targeted interventions aimed at reducing both cognitive and practical barriers. Abbreviations aOR – Adjusted Odds Ratio cOR – Crude Odds Ratio DHAP – Dihydroartemisinin-piperaquine IQR – Interquartile Range LaDMA – La Dade-Kotopon Municipality MDA – Mass Drug Administration MMDAs – Metropolitan Municipal District Assemblies NMESP – National Malaria Elimination Strategic Plan NMIMR - Noguchi Memorial Institute for Scientific Research TFA – Theoretical Framework of Acceptability WHO – World Health Organization Declarations Author contributions H.A.B and P.A conceptualized and designed the study. P.A oversaw data collection from the field. P.A, H.I and H.A.B analyzed and interpretated the data. P.A drafted the initial manuscript. H.I and H.A.B reviewed and edited the manuscript. All authors reviewed and approved the submitted version of this manuscript. Acknowledgement We sincerely thank the data collection team for their dedication and diligence, and we are deeply grateful to all study participants for generously giving their time and responding to the research instruments. Funding Authors received no financial support for this study. Availability of data and materials The data supporting the study findings is available from the corresponding author ( [email protected] ) upon reasonable request. Ethics approval and consent to participate This study was granted ethical approval from the Institutional Review Board of the Noguchi Memorial Institute for Scientific Research (NMIMR-IRB CPN 029/25-26). Informed consent was obtained from the study participants. The study was conducted in accordance with the Declaration of Helsinki. Consent for Publication Non applicable Competing Interest The authors declare no competing interest References World Health Organization. World malaria report 2024: addressing inequity in the global malaria response [Internet]. 2024 [cited 2025 Jan 18]. Available from: https://iris.who.int/bitstream/handle/10665/379751/9789240104440-eng.pdf?sequence=1 Awine T, Malm K, Bart-Plange C, Silal SP. Towards malaria control and elimination in Ghana: challenges and decision making tools to guide planning. Glob Health Action. 2017 Oct 16;10(1):1381471. doi:10.1080/16549716.2017.1381471 PubMed PMID: 29035160; PubMed Central PMCID: PMC5678345. Ministry of Health, Ghana Health Service. National Malaria Elimination Strategic Plan (NMESP) of Ghana: 2024 - 2028 [Internet]. 2023 [cited 2025 Jan 25]. Available from: https://ghs.gov.gh/wp-content/uploads/2023/12/NMEP-STRATEGIC%20PLAN%202024-2028.pdf Dosoo DK, Adu GA, Kingsley K, Odei-Lartey E, Adomako K, Atuguba F, et al. Prevalence and factors associated with malaria among children aged 6 months to 10 years in the Greater Accra Region of Ghana: a community-based cross-sectional survey. Malar J. 2024 Sep 27;23(1):289. doi:10.1186/s12936-024-05109-4 World Health Organization - 2017 - Mass drug administration for falciparum malaria a.pdf. Schneider ZD, Shah MP, Boily MC, Busbee AL, Hwang J, Lindblade KA, et al. Mass Drug Administration to Reduce Malaria Transmission: A Systematic Review and Meta-Analysis. Am J Trop Med Hyg. 2024 Apr;110(4 Suppl):17–29. doi:10.4269/ajtmh.22-0766 PubMed PMID: 38118174; PubMed Central PMCID: PMC10993786. Wattanakul T, Ogutu B, Kabanywanyi AM, Asante KP, Oduro A, Adjei A, et al. Pooled Multicenter Analysis of Cardiovascular Safety and Population Pharmacokinetic Properties of Piperaquine in African Patients with Uncomplicated Falciparum Malaria. Antimicrob Agents Chemother. 2020 Jun 23;64(7):e01848-19. doi:10.1128/AAC.01848-19 Abuaku B, Boateng P, Peprah NY, Asamoah A, Duah-Quashie NO, Matrevi SA, et al. Therapeutic efficacy of dihydroartemisinin-piperaquine combination for the treatment of uncomplicated malaria in Ghana. Front Cell Infect Microbiol. 2023 Jan 6;12:1058660. doi:10.3389/fcimb.2022.1058660 PubMed PMID: 36683700; PubMed Central PMCID: PMC9853013. Daniels RF, Schaffner SF, Bennett A, Porter TR, Yukich JO, Mulube C, et al. Evidence for Reduced Malaria Parasite Population after Application of Population-Level Antimalarial Drug Strategies in Southern Province, Zambia. Am J Trop Med Hyg. 2020 Aug 6;103(2_Suppl):66–73. doi:10.4269/ajtmh.19-0666 Asante KP, Abokyi L, Zandoh C, Owusu R, Awini E, Sulemana A, et al. Community perceptions of malaria and malaria treatment behaviour in a rural district of Ghana: implications for artemisinin combination therapy. BMC Public Health. 2010 Jul 12;10:409. doi:10.1186/1471-2458-10-409 PubMed PMID: 20624306; PubMed Central PMCID: PMC2914078. Shah MP, Hwang J, Choi L, Lindblade KA, Kachur SP, Desai M. Mass drug administration for malaria. Cochrane Database Syst Rev. 2021 Sep 29;2021(9):CD008846. doi:10.1002/14651858.CD008846.pub3 PubMed PMID: 34585740; PubMed Central PMCID: PMC8479726. Cuinhane CE, Galatas B, Lopez JM, Djive H, Nhantumbo H, Murato I, et al. Acceptability and perceived barriers to reactive focal mass drug administration in the context of a malaria elimination program in Magude district, Southern Mozambique: A qualitative study. Vieira JLF, editor. PLOS ONE. 2023 Mar 31;18(3):e0283160. doi:10.1371/journal.pone.0283160 Pell CL, Adhikari B, Thwin MM, Kajeechiwa L, Nosten S, Nosten FH, et al. Community engagement, social context and coverage of mass anti-malarial administration: Comparative findings from multi-site research in the Greater Mekong sub-Region. PLOS ONE. 2019 Mar 25;14(3):e0214280. doi:10.1371/journal.pone.0214280 Kajeechiwa L, Thwin MM, Nosten S, Tun SW, Parker D, von Seidlein L, et al. Community engagement for the rapid elimination of malaria: the case of Kayin State, Myanmar. Wellcome Open Res. 2017 Jul 28;2:59. doi:10.12688/wellcomeopenres.12051.1 PubMed PMID: 28894847; PubMed Central PMCID: PMC5580421. Adhikari B, Phommasone K, Kommarasy P, Soundala X, Souvanthong P, Pongvongsa T, et al. Why do people participate in mass anti-malarial administration? Findings from a qualitative study in Nong District, Savannakhet Province, Lao PDR (Laos). Malar J. 2018 Jan 9;17(1):15. doi:10.1186/s12936-017-2158-4 Hoefle-Bénard J, Salloch S. Mass drug administration for neglected tropical disease control and elimination: a systematic review of ethical reasons. BMJ Glob Health. 2024 Mar;9(3):e013439. doi:10.1136/bmjgh-2023-013439 Asante FA, Asenso-Okyere K. Economic Burden of Malaria in Ghana. 2003 Nov;1–81. Ndong IC, Okyere D, Enos JY, Amambua-Ngwa A, Merle CSC, Nyarko A, et al. Challenges and perceptions of implementing mass testing, treatment and tracking in malaria control: a qualitative study in Pakro sub-district of Ghana. BMC Public Health. 2019 Dec;19(1):695. doi:10.1186/s12889-019-7037-1 Tindana P, Vries J, Campbell M, Littler K, Seeley J, Marshall P, et al. Community engagement strategies for genomic studies in Africa: A review of the literature. BMC Med Ethics. 2015 Apr 12;16:24. doi:10.1186/s12910-015-0014-z Galatas B, Nhantumbo H, Soares R, Djive H, Murato I, Simone W, et al. Community acceptability to antimalarial mass drug administrations in Magude district, Southern Mozambique: A mixed methods study. PLOS ONE. 2021 Mar 23;16(3):e0249080. doi:10.1371/journal.pone.0249080 Sekhon M, Cartwright M, Francis JJ. Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions. BMC Health Serv Res. 2022 Mar 1;22(1):279. doi:10.1186/s12913-022-07577-3 Sekhon M, Cartwright M, Francis JJ. Acceptability of healthcare interventions: an overview of reviews and development of a theoretical framework. BMC Health Serv Res. 2017 Jan 26;17(1):88. doi:10.1186/s12913-017-2031-8 Ahorlu CK, Dunyo SK, Afari EA, Koram KA, Nkrumah FK. Malaria-related beliefs and behaviour in southern Ghana: Implications for treatment, prevention and control. Trop Med Int Health. 1997;2(5):488–99. doi:10.1111/j.1365-3156.1997.tb00172.x Owusu EDA, Cremers AL, Brown CA, Mens PF, Grobusch MP. Knowledge, attitudes and practices regarding malaria in people living with HIV in rural and urban Ghana. Acta Trop. 2018 May 1;181:16–20. doi:10.1016/j.actatropica.2018.01.016 Afoakwah C, Deng X, Onur I. Malaria infection among children under-five: the use of large-scale interventions in Ghana. BMC Public Health. 2018 Apr 23;18:536. doi:10.1186/s12889-018-5428-3 PubMed PMID: 29685120; PubMed Central PMCID: PMC5913887. Ahorlu CSK, Koka E, Adu-Amankwah S, Otchere J, de Souza DK. Community perspectives on persistent transmission of lymphatic filariasis in three hotspot districts in Ghana after 15 rounds of mass drug administration: a qualitative assessment. BMC Public Health. 2018 Feb 13;18(1):238. doi:10.1186/s12889-018-5157-7 Aboagye IF, Addison YAA. The Impact of Mass Drug Administration on Lymphatic Filariasis. J Trop Med. 2022;2022(1):7504871. doi:10.1155/2022/7504871 Barry L, Andah NL, Sidibé S, Delamou A, Dako-Gyeke P. Community perspectives on anti-helminthiasis mass drug administration for school-age children in Ghana. Front Trop Dis. 2025 Aug 28;6. doi:10.3389/fitd.2025.1553488 Ghana Statistical Service. Ghana 2021 Population and Housing Census [Internet]. 2021. Available from: https://statsghana.gov.gh/gssmain/fileUpload/pressrelease/2021%20PHC%20General%20Report%20Vol%203A_Population%20of%20Regions%20and%20Districts_181121.pdf Mulebeke R, Wanzira H, Bukenya F, Eganyu T, Collborn K, Elliot R, et al. Implementing population-based mass drug administration for malaria: experience from a high transmission setting in North Eastern Uganda. Malar J. 2019 Dec;18(1):271. doi:10.1186/s12936-019-2902-z Suresh K, Chandrashekara S. Sample size estimation and power analysis for clinical research studies. J Hum Reprod Sci. 2012;5(1):7–13. doi:10.4103/0974-1208.97779 PubMed PMID: 22870008; PubMed Central PMCID: PMC3409926. Legendre E, Ndiaye A, Sougou NM, Gaudart J, Ba EH, Ridde V, et al. Prospective acceptability of mass drug administration for malaria in Kedougou region in Senegal: a mixed method study. Malar J. 2024 Sep 16;23(1):279. doi:10.1186/s12936-024-05078-8 Deeks A, Lombard C, Michelmore J, Teede H. The effects of gender and age on health related behaviors. BMC Public Health. 2009 Dec;9(1):213. doi:10.1186/1471-2458-9-213 Raghupathi V, Raghupathi W. The influence of education on health: an empirical assessment of OECD countries for the period 1995–2015. Arch Public Health. 2020 Dec;78(1):20. doi:10.1186/s13690-020-00402-5 Sangare M, Coulibaly YI, Diabate AF, Dolo H, Koureichi MM, Diarra D, et al. Factors associated with low coverage in mass drug administration for schistosomiasis in mobile populations in Mali: a cross-sectional study. BMC Infect Dis. 2025 Oct 7;25(1):1240. doi:10.1186/s12879-025-11626-7 Abdul Halim AFN, Ahmad D, Miaw Yn JL, Masdor NA, Ramly N, Othman R, et al. Factors Associated with the Acceptability of Mass Drug Administration for Filariasis: A Systematic Review. Int J Environ Res Public Health. 2022 Jan;19(19):19. doi:10.3390/ijerph191912971 Silumbe K, Chiyende E, Finn TP, Desmond M, Puta C, Hamainza B, et al. A qualitative study of perceptions of a mass test and treat campaign in Southern Zambia and potential barriers to effectiveness. Malar J. 2015 Dec;14(1):171. doi:10.1186/s12936-015-0686-3 Additional Declarations No competing interests reported. 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According to the World Health Organization, there were an estimated 263\u0026nbsp;million cases of malaria and 597,000 deaths worldwide in 2023, with approximately 95% of these fatalities occurring in the African Region (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Despite the intensified effort in reducing the global malaria burden, a substantial number of individuals at risk in this region continue to lack access to essential services for the prevention, diagnosis, and treatment of the disease (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMalaria remains endemic in Ghana contributing about 2.5% to the global prevalence (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). However, the country has made progress in malaria control over the past decade through key interventions such as distribution of LLINs, indoor residual spraying, improved case management, malaria vaccination programs, and strengthened surveillance systems (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Although these efforts have contributed to a decline in malaria prevalence in the country (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e), sustained transmissions in areas that are potential hotspots for asymptomatic transmissions (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) may require additional interventions such as Mass Drug Administration (MDA).\u003c/p\u003e \u003cp\u003eMDA involves the provision of a complete therapeutic course of antimalarial medication to all individuals within a defined population or geographical area, irrespective of the presence of symptoms or infection status, except for those for whom the medication is contraindicated (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). This intervention typically occurs simultaneously and at repeated intervals (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The primary objective of this strategy is to minimize community-level transmission by reducing the human reservoir of the malaria parasite, thereby preventing future infections (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Current malaria treatment strategies primarily utilize artemisinin-based combination therapies (ACTs), which are recommended by the World Health Organization (WHO) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). One notable ACT is dihydroartemisinin-piperaquine (DHAP), recognized for its high efficacy in eliminating \u003cem\u003ePlasmodium falciparum\u003c/em\u003e infections while providing extended prophylactic protection against subsequent infections (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The prolonged elimination half-life of piperaquine sustains drug levels in the body, rendering it particularly advantageous for (MDA) programs (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn 2020, DHAP was adopted as a second-line antimalarial treatment for uncomplicated malaria in Ghana following a comprehensive review of the country's antimalarial medicines policy (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The utilization of (DHAP) in MDA is substantiated by its effectiveness in significantly decreasing the malaria parasite reservoir within a community (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) By administering DHAP to entire populations, including asymptomatic individuals, MDA can disrupt transmission cycles and contribute to the prevention of new infections. Previous MDA campaigns employing DHAP have yielded positive outcomes, resulting in reductions in both the incidence and prevalence of malaria, thereby underscoring its potential as a crucial component in malaria elimination strategies (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDespite the potential benefits of DHAP in MDA, community acceptance is crucial for the success of these interventions. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). A systematic review involving 10 countries, 3 regions in Africa revealed that MDA coverage ranged from 75% to 91% per round in the four-week low frequency MDA arm and 84% to 97% per round in the two‐week high frequency MDA arm (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Factors such as fear of side effects, a lack of perceived need, and cultural beliefs can influence individuals' decisions to participate in MDA campaigns (\u003cspan additionalcitationids=\"CR13 CR14 CR15\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Previous studies in Ghana have also indicated that community perceptions and the willingness to embrace new treatments significantly impact the effectiveness of malaria control programs (\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Furthermore, acceptability of health interventions has been reported to be mainly driven by intensified community engagement campaigns constantly adapted to the local context, and a delivery strategy that promotes community ownership and trust (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Therefore, understanding these factors is essential for designing effective community engagement strategies that enhance the acceptance and adherence to this intervention.\u003c/p\u003e \u003cp\u003eTo better understand individual\u0026rsquo;s perceptions of health interventions, theory-based approaches have increasingly been recommended. The Theoretical Framework of Acceptability (TFA) developed by Sekhon and colleagues defines acceptability as a multi-dimensional construct reflecting individual\u0026rsquo;s cognitive and emotional responses to an intervention (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The framework identifies seven key components that influence intervention acceptability: affective attitude, burden, perceived effectiveness, ethicality, intervention coherence, opportunity costs, and self-efficacy (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). By examining these dimensions, the framework provides a useful conceptual approach for evaluating how individuals perceive and respond to health interventions (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eWith the shift towards malaria elimination in Ghana and the adoption of malaria MDA as one of the elimination interventions, empirical evidence on population willingness to participate in malaria-specific MDA programs using dihydroartemisinin-piperaquine is a prerequisite for program planning and implementation. While previous studies have examined malaria knowledge, prevention practices, and treatment behaviors in Ghana (\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), limited research has applied a theory-driven framework to assess the acceptability of malaria MDA interventions, particularly in urban settings. Furthermore, earlier studies on MDA acceptability in Ghana have focused largely on neglected tropical diseases (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan additionalcitationids=\"CR27\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).The current study contributes to knowledge on the willingness of adults to accept MDA for malaria elimination and explores factors influencing its acceptability in urban Accra aiming to inform the planning and implementation of malaria MDA programs in Ghana.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eThis study employed a cross-sectional study design and was conducted in the La Dade-Kotopon Municipal Assembly (LaDMA), which is one of the 261 Metropolitan, Municipal, and District Assemblies (MMDAs) in Ghana. LaDMA has a population of 140,264 with 48.6% males (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Data were collected from October to November 2025.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSample size calculation and sampling procedure\u003c/h3\u003e\n\u003cp\u003eThe sample size for this study was estimated using the Cochran's formula for sample size determination (Cochran, 1977). A study on implementing population-based mass drug administration for malaria in North east Uganda recorded an average prevalence of 80% across the four rounds of MDA intervention (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Using this prevalence, the minimum sample size required for this study was 246. Adjusting for a design effect of 1.5 (a common conservative estimate for public health surveys using cluster sampling), (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e) the sample size was calculated as 369. A 10% non-response rate was considered, bringing the sample size for this study to 406 participants.\u003c/p\u003e \u003cp\u003eA step-by-step stratified procedure was used to select the study participants by sampling at the community and household levels. La and Burma Camp communities were purposively selected and divided into smaller zones using natural boundaries like roads or landmarks. These two communities were the most populated communities out of the nine communities in LaDMA and suggested a good representation of the municipality. Number of households in each zone were estimated and samples allocated proportionately across each zone. A random starting point was chosen by tossing a coin then every 5th household was sampled. In each selected household one eligible participant was randomly recruited and interviewed.\u003c/p\u003e\n\u003ch3\u003eEligibility Criteria\u003c/h3\u003e\n\u003cp\u003eIndividuals who were 18 years old and above and had lived in the selected community for more than 6 months were included in the study. Apparently sick community members were excluded from the study.\u003c/p\u003e\n\u003ch3\u003eData Collection and Analysis\u003c/h3\u003e\n\u003cp\u003eA theory-informed questionnaire for assessing the acceptability of healthcare interventions (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e) was adapted. The questionnaires were administered to adults aged 18 years and above residing in the selected communities in LaDMA. Questionnaires were structured to collect information on sociodemographic characteristics of participants as well as their lived experiences with malaria and cultural beliefs. The primary outcome, acceptability of MDA was assessed using the Theoretical Framework of Acceptability (TFA) constructs (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The outcome variable, acceptability of MDA was measured using the seven TFA construct of acceptability; perceived effectiveness, affective attitude, intervention coherence, self-efficacy, ethicality, opportunity cost and burden. The seven TFA construct of acceptability were measured on a 5-point Likert scale. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Two research assistants were recruited to collect data using the KoboCollect app after training and pretesting data collection tool at Teshie.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eData was downloaded from KoboCollect tool onto an excel sheet and imported to Stata version 17. Data was cleaned by verifying completeness, accuracy, and consistency. All incomplete responses were deleted. Each variable was appropriately coded for efficient input into statistical software. For this study, an aggregate/mean score of 7\u0026ndash;24 equals \u003cem\u003eUnacceptable\u003c/em\u003e and an aggregate/mean score of 25\u0026ndash;35 equals \u003cem\u003eAcceptable\u003c/em\u003e (\u003cb\u003eSupplementary information\u003c/b\u003e). The dichotomized aggregate/mean score of the TFA constructs was used as the outcome variable. Descriptive statistics of the socio-demographic factors, cultural beliefs and lived Malaria experiences as well as the seven TFA constructs were computed. Bivariate analysis was used to determine the association between the independent variables and the outcome variables. Univariate and multivariate logistic regression was used to further identify the predictors of willingness to accept MDA. For categorical predictors with multiple levels, the overall significance was assessed using Likelihood Ratio (LR) tests, comparing the full model to nested model excluding the variables in question. Finally, model goodness-of-fit was evaluated using Hosmer-Lemeshow test (g\u0026thinsp;=\u0026thinsp;10). A non-significant p-value (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) on the Hosmer-Lemeshow test was used to indicate that the model\u0026rsquo;s predicted probabilities were well-calibrated with the observed data. Analysis was performed at 95% CI and 0.05 precision level.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eSociodemographic characteristics of study participants\u003c/h2\u003e \u003cp\u003eMajority (72.0%, 95% CI: 67.0\u0026ndash;76.0) of participants were residents of La. The median (IQR) age of participants was 33 (27\u0026ndash;44). More than half (57.5%, 95% CI: 53.0\u0026ndash;62.0) of the participants were females. With level of education, participants who attained only primary education formed the majority (34.4%, 95% CI: 30.0\u0026ndash;39.0). Nearly 80% (95% CI: 75.0\u0026ndash;83.0) of the participants were employed. Majority of the participants (28. 0%, 95% CI: 24.0\u0026ndash;33.0) refused disclosure of their monthly income while the least represented group (5.7%, 95% CI: 4.0\u0026ndash;8.0) earn 5000 Ghana cedis and above. Christianity was the most represented (72.7%, 95% CI: 68.0\u0026ndash;77.0) religion and majority (40.1%, 95% CI: 57.0\u0026ndash;67.0) of the participants were of the Ga tribe (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of study participants in LaDMA\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable/\u003c/p\u003e \u003cp\u003eCharacteristic (n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedian age, IQR (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCommunity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e303\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBurma Camp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e179\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e57.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnskilled labor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled trade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessional\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdministrative/Clerical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eService industry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecurity service\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePensioner\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCan\u0026rsquo;t disclose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBelow GHS 500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 500\u0026ndash;1499\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 1500\u0026ndash;2999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 3000\u0026ndash;4999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 5000 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e306\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTraditional African religion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTribe\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAkan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEwe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFante\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eLived Malaria Experiences and Cultural Beliefs of Study Participants\u003c/h3\u003e\n\u003cp\u003eMajority (80.3%, 95% CI: 76.0\u0026ndash;84.0) reported that they have ever been diagnosed with malaria. Regarding cultural permissions to taking medication even when one does not feel sick in the context of MDA, 66.3% (95% CI: 26.0\u0026ndash;35.0) of the participants disagreed. However, with participants\u0026rsquo; action for community wellbeing by participating in MDA, over 70% (95% CI: 71.0\u0026ndash;79.0) of the participants agreed (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eLived malaria experiences and cultural beliefs of study participants\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable/\u003c/p\u003e \u003cp\u003eCharacteristic (n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevious malaria diagnosis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e338\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCultural permissions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e228\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCommunity wellbeing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e164\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eThe Seven TFA constructs of MDA Acceptability\u003c/h2\u003e \u003cp\u003eMore than half (53.9%) of the participants reported being comfortable with taking malaria medicine even when they do not feel sick. For perceived effectiveness, 70.8% of the participants agreed that malaria MDA medicine is likely to increase their chances of not being seriously sick with malaria. Majority (74.8%) of the participants reported clear understanding that participating in the malaria MDA reduces their risk of becoming seriously sick with Malaria. A little over seventy percent (71.3%) of participants felt confident adhering to the treatment regimen of the malaria MDA medicine. Nearly two-thirds (65.8%) of participants perceived that it would take them no effort to participate in the Malaria MDA program. Majority (70.6%) of the participants disagreed that the Malaria MDA program will interfere with their other priorities. For ethicality, 73.2% of the participants said the malaria MDA program is fair (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStudy participants response to The Seven TFA construct\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable/Characteristic (n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eFrequency (n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAffective attitude\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVery uncomfortable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eUncomfortable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e132\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eComfortable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVery comfortable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePerceived effectiveness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e262\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIntervention coherence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSelf-efficacy\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVery unconfident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eUnconfident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eConfident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e198\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVery confident\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBurden\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo effort at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eA little effort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eA lot of effort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eHuge effort\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOpportunity cost\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly disagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e12.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e244\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e58.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e6.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStrongly agree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEthicality\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery unfair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnfair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e10.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo opinion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e211\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e50.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVery fair\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e23.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of Malaria MDA Acceptability in the La Dade-Kotopon Municipality\u003c/h2\u003e \u003cp\u003eMajority of the participants (58.7%, 95% CI: 54.0\u0026ndash;63.0) reported the malaria MDA program acceptable (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eBivariate Analysis of Malaria MDA Acceptability and Independent Variables\u003c/h2\u003e \u003cp\u003eThe chi-square analysis showed that participants\u0026rsquo; age (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), community resided (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004), level of education (p\u0026thinsp;=\u0026thinsp;0.033), occupation (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.003), monthly income (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.042), religion (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), tribe (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), cultural permissions (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.022) and community wellbeing (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly associated with MDA acceptability. However, variables such as sex of participants, employment status and previous malaria diagnosis were not significantly associated with MDA acceptability (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eChi-square test of association of MDA acceptability and independent variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable/\u003c/p\u003e \u003cp\u003eCharacteristic (n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnacceptable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAcceptable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eChi-square value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51(32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108(67.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e18.677\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43(37.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72(62.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42(53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36(46.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28(60.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18(39.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10(43.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(56.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCommunity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBurma Camp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e62(52.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56(47.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e8.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e112(37.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e191(63.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71(39.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108(60.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.551\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemales\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e103(42.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139(57.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56(38.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e89(61.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e6.820\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003e0.033\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51(35.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92(64.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67(50.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66(49.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdministrative/Clerical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16(40.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(60.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e19.524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePensioners\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(31.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(68.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e26(41.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36(58.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecurity services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(67.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(32.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eService industry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8(22.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(77.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled trade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56(48.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59(51.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnskilled labor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42(34.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80(65.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e142(42.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e192(57.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.936\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.333\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(36.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55(63.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCan\u0026rsquo;t disclose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58(49.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(50.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e11.498\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e\u003cb\u003e0.042\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBelow GHS 500.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9(25.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26(74.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 500.00\u0026ndash;1499.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(36.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55(63.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 1500.00\u0026ndash;2999.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28(35.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(65.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 3000.00\u0026ndash;4999.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33(42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44(57.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 5000.00 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14(58.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(41.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e82(26.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e224(73.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e100.249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31(70.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(29.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther religions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e61(85.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10(14.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTribe\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAkan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(38.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56(61.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e27.630\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEwe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32(58.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23(41.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFante\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15(51.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(48.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48(28.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121(71.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44(57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33(42.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrevious Malaria Diagnosis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40(48.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43(51.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.156\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e134(39.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e204(60.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCultural permissions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e110(37.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e182(62.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64(49.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65(50.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCommunity wellbeing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e97(92.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8(7.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e150.351\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77(24.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e239(75.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eFactors Associated with Malaria MDA Acceptability\u003c/h2\u003e \u003cp\u003eFrom the multivariate regression model, age of participants, level of education, religion, tribe, cultural beliefs and community wellbeing were significantly associated with the malaria MDA acceptability. Participants aged 50\u0026ndash;59 years had 66% lower odds of the malaria MDA acceptability (aOR\u0026thinsp;=\u0026thinsp;0.34, 95% CI: 0.11\u0026ndash;0.95, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.040) and those aged 60 years and above had 88% lower odds of the malaria MDA acceptability (aOR\u0026thinsp;=\u0026thinsp;0.12, 95% CI: 0.02\u0026ndash;0.78, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.027) compared to those aged 18\u0026ndash;29 years. Those with tertiary education were 72% less likely to accept the Malaria MDA compared to those with only primary education (aOR\u0026thinsp;=\u0026thinsp;0.28, 95% CI\u0026thinsp;=\u0026thinsp;0.09\u0026ndash;0.86, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.027). Muslims were 82% less likely to accept the malaria MDA (aOR\u0026thinsp;=\u0026thinsp;0.18, 95%CI: 0.07\u0026ndash;0.46, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and those belonging to other religions were 90% less likely to accept the malaria MDA (aOR\u0026thinsp;=\u0026thinsp;0.10, 95% CI: 0.04\u0026ndash;0.25, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) compared to Christians. Ewes were 68% less likely to accept the malaria MDA compared to Gas (aOR\u0026thinsp;=\u0026thinsp;0.32, 95% CI: 0.12\u0026ndash;0.82, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.019). Participants who agreed that they will participate in malaria MDA programs for their community\u0026rsquo;s wellbeing were 45.29 times more likely to participate compared to their counterparts (aOR\u0026thinsp;=\u0026thinsp;46.29, 95% CI: 18.32\u0026ndash;116.99, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eA likelihood ratio test confirmed that age, level of education and tribe were significant predictors of MDA acceptability, \u003cem\u003ex\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u0026thinsp;=\u0026thinsp;139.95, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001, despite some individual categories not reaching significance. The Hosmer-Lemeshow test also indicated that the model was well-calibrated, \u003cem\u003ex\u003c/em\u003e\u003csup\u003e2\u003c/sup\u003e (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u0026thinsp;=\u0026thinsp;14.68, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.0657.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eUnivariate and multivariate logistic regression estimates of the predictors of MDA acceptability\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables/\u003c/p\u003e \u003cp\u003eCharacteristic(n\u0026thinsp;=\u0026thinsp;421)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ecOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eaOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group (Years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.79 (0.48\u0026ndash;1.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.361\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.80 (0.37\u0026ndash;1.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.581\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.41 (0.23\u0026ndash;0.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.65 (0.26\u0026ndash;1.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.376\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.30 (0.15\u0026ndash;0.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.34 (0.11\u0026ndash;0.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.040*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e60 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.61 (0.25\u0026ndash;1.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.281\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.12 (0.02\u0026ndash;0.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.027*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCommunity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBurma Camp\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.53 (0.34\u0026ndash;0.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.58 (0.30\u0026ndash;1.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.110\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.14 (0.70\u0026ndash;1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.604\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.54 (0.24\u0026ndash;1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.154\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.62 (0.38\u0026ndash;1.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.049\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.28 (0.09\u0026ndash;0.86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.027*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnskilled labor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAdministrative/Clerical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.79 (0.38\u0026ndash;1.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.524\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.77 (0.88\u0026ndash;16.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.074\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePensioners\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.16 (0.38\u0026ndash;3.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.801\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.87 (0.64\u0026ndash;54.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.119\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.73 (0.39\u0026ndash;1.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.319\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.25 (0.36\u0026ndash;4.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.723\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecurity services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.25 (0.11\u0026ndash;0.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.54 (0.13\u0026ndash;2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.397\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eService industry\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.77 (0.74\u0026ndash;4.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.15 (0.32\u0026ndash;4.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.828\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled trade\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.55 (0.33\u0026ndash;0.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.026\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.50 (0.22\u0026ndash;1.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.089\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMonthly income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCan\u0026rsquo;t disclose\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBelow GHS 500.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.79 (1.21\u0026ndash;6.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.68 (0.45\u0026ndash;6.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.436\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 500.00\u0026ndash;1499.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.66 (0.94\u0026ndash;2.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.77 (0.32\u0026ndash;1.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.553\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 1500.00\u0026ndash;2999.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.80 (1.00\u0026ndash;3.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.050\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.39 (0.57\u0026ndash;3.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.471\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 3000.00\u0026ndash;4999.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.29 (0.72\u0026ndash;2.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.389\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.91 (0.74\u0026ndash;4.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.181\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGHS 5000.00 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.69 (0.28\u0026ndash;1.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.414\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.94 (0.24\u0026ndash;3.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.933\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eReligion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChristianity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIslam\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.15 (0.08\u0026ndash;0.31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.18 (0.07\u0026ndash;0.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther religions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.06 (0.03\u0026ndash;0.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.10 (0.04\u0026ndash;0.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTribe\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAkan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.63 (0.37\u0026ndash;1.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.098)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.75 (0.35\u0026ndash;1.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.470\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEwe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.29 (0.15\u0026ndash;0.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.32 (0.12\u0026ndash;0.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.019*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFante\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.37 (0.17\u0026ndash;0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.015\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.75 (0.22\u0026ndash;2.58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.650\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.30 (0.17\u0026ndash;0.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.66 (0.27\u0026ndash;1.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.353\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCultural permissions\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.61 (0.40\u0026ndash;0.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.86 (0.43\u0026ndash;1.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.660\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCommunity wellbeing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRef\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.63 (17.51\u0026ndash;80.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.29 (18.32\u0026ndash;116.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003e*Statistically significant\u003c/h2\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study reports that the willingness to accept malaria MDA in LaDMA is generally moderate. Most participants demonstrated a favourable emotional disposition, recognized the intervention as coherent, effective, and aligned with their values, and felt capable of participating, suggesting that uptake and adherence could be promising if the intervention is implemented. The relatively low perceived burden and acceptable opportunity costs further support participation. However, the presence of a minority expressing discomfort, concerns regarding burden or cost, or uncertainty indicates that universal uptake cannot be guaranteed; these sub-groups may require additional information, reassurance, or tailored engagement strategies to convert willingness into actual participation. Finding from this study is similar to that of Legendre et al, recent mixed-methods study conducted in the high-malaria burden region of Kedougou, Senegal, utilizing the same seven-construct framework where acceptability was found to be good (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Additionally, they identified that a comprehensive understanding of MDA, a strong perception of effectiveness, and acknowledgment of malaria as a significant burden were key facilitators of acceptability. Conversely, the primary barriers identified were concerns regarding side effects and the reluctance to take medication while asymptomatic (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this study, age was found to be associated with willingness to accept malaria MDA. Participants who were 50 years and above had lower odds of accepting MDA. This could be because older adults may find it difficult to adapt to new health interventions. The findings are consistent with the findings from another study which indicates that age can influence health behaviors, with younger individuals often demonstrating greater adaptability to new health strategies (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). However, it is also essential to acknowledge that older adults may possess distinct health beliefs and needs (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eEducation is correlated with health outcomes, as higher educational attainment is associated with improved health knowledge, increased access to resources, and enhanced health behaviors (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Contrary to these conventional assumptions that higher education predicts greater health intervention uptake, individuals with tertiary education in this study were less likely to accept MDA. This may be because individuals with higher educational attainment are likely to scrutinize and question population-wide health interventions. Therefore, interventions should be designed to accommodate varying levels of understanding and to tailor communication strategies accordingly (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Income levels varied significantly; however, a substantial portion (28%) chose not to disclose their income. This socio-economic diversity suggests that any mass drug administration (MDA) program in the municipality must effectively reach a wide range of livelihoods, from low-income informal laborers to higher-income professionals. Consequently, the implementation of MDA cannot assume uniform participation based solely on economic or occupational status. Individuals employed in unskilled or informal sectors, particularly those with low or unstable incomes, may exhibit a higher risk of non-participation due to factors such as mobility, absence during distribution times, or limited access to information. On the other hand, higher-income or formally employed individuals may also choose to opt out, especially if they perceive the risk of malaria as low or harbor mistrust toward the intervention. This highlights the necessity for tailored and adaptable outreach and distribution strategies. Prior research indicates that non-participation in MDA is strongly linked to occupation such as livestock breeding or other mobility-related trades, and lower income (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe high prior malaria prevalence may increase perceived need for MDA, which often correlates with acceptability. However, concerns about negative effects and mixed support for cultural/religious permission suggest that uptake may not be uniform and thus, religious and ethnic identity may influence acceptability and adherence. Therefore, any MDA program in this context must not only communicate benefits but also actively address religious and cultural concerns to maximize coverage and compliance. In a systematic review of MDA for neglected tropical diseases, it was observed that religious and traditional beliefs can impede uptake, particularly in communities that rely on faith-based healing or interpret illness through non-biomedical perspectives. (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). In the context of malaria-specific MDA and test-and-treat initiatives, studies have identified refusals associated with religious objections, mistrust of healthcare workers, concerns regarding blood draws or medications, and the belief that preventive treatment is unnecessary for asymptomatic individuals (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). In contrast, acceptance of MDA tends to be higher among individuals and communities that recognize malaria as a significant burden, understand the rationale behind MDA, and view it as beneficial to community wellbeing (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Overall, understanding these nuances is essential for the design of effective and inclusive MDA initiatives.\u003c/p\u003e \u003cp\u003eA few limitations were identified in this study. This study relied on self-reported data and this may have introduced social desirability bias, potentially leading to overestimation of acceptability toward mass drug administration. Additionally, the findings of this study may only be generalizable to communities similar to the study area.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003e More than half of the participants (~\u0026thinsp;59%) indicated a willingness to accept MDA, reflecting a moderate level of acceptability within the community. Key enabling factors included older age, higher educational attainment, skilled occupations, and recognition of the communal benefits of MDA. In contrast, younger age groups, lower educational levels, unskilled labour, and minority religious affiliations were associated with lower acceptability. While a significant number of adults are willing to participate in malaria MDA programs, achieving the community level high coverage require targeted interventions aimed at reducing both cognitive and practical barriers.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eaOR\u003c/strong\u003e \u0026ndash; Adjusted Odds Ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ecOR\u003c/strong\u003e \u0026ndash; Crude Odds Ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDHAP\u003c/strong\u003e \u0026ndash; Dihydroartemisinin-piperaquine\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIQR\u003c/strong\u003e \u0026ndash; Interquartile Range\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLaDMA\u003c/strong\u003e \u0026ndash; La Dade-Kotopon Municipality\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMDA\u003c/strong\u003e \u0026ndash; Mass Drug Administration\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMMDAs\u003c/strong\u003e \u0026ndash; Metropolitan Municipal District Assemblies\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNMESP\u003c/strong\u003e \u0026ndash; National Malaria Elimination Strategic Plan\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNMIMR\u0026nbsp;\u003c/strong\u003e- Noguchi Memorial Institute for Scientific Research\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTFA\u003c/strong\u003e \u0026ndash; Theoretical Framework of Acceptability\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWHO\u003c/strong\u003e \u0026ndash; World Health Organization\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eH.A.B and P.A conceptualized and designed the study. P.A oversaw data collection from the field. P.A, H.I and H.A.B analyzed and interpretated the data. P.A drafted the initial manuscript. H.I and H.A.B reviewed and edited the manuscript. All authors reviewed and approved the submitted version of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely thank the data collection team for their dedication and diligence, and we are deeply grateful to all study participants for generously giving their time and responding to the research instruments.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors received no financial support for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data supporting the study findings is available from the corresponding author ([email protected]) upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was granted ethical approval from the Institutional Review Board of the Noguchi Memorial Institute for Scientific Research (NMIMR-IRB CPN 029/25-26). Informed consent was obtained from the study participants. The study was conducted in accordance with the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNon applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interest\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization. World malaria report 2024: addressing inequity in the global malaria response [Internet]. 2024 [cited 2025 Jan 18]. Available from: https://iris.who.int/bitstream/handle/10665/379751/9789240104440-eng.pdf?sequence=1\u003c/li\u003e\n\u003cli\u003eAwine T, Malm K, Bart-Plange C, Silal SP. Towards malaria control and elimination in Ghana: challenges and decision making tools to guide planning. 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Arch Public Health. 2020 Dec;78(1):20. doi:10.1186/s13690-020-00402-5\u003c/li\u003e\n\u003cli\u003eSangare M, Coulibaly YI, Diabate AF, Dolo H, Koureichi MM, Diarra D, et al. Factors associated with low coverage in mass drug administration for schistosomiasis in mobile populations in Mali: a cross-sectional study. BMC Infect Dis. 2025 Oct 7;25(1):1240. doi:10.1186/s12879-025-11626-7\u003c/li\u003e\n\u003cli\u003eAbdul Halim AFN, Ahmad D, Miaw Yn JL, Masdor NA, Ramly N, Othman R, et al. Factors Associated with the Acceptability of Mass Drug Administration for Filariasis: A Systematic Review. Int J Environ Res Public Health. 2022 Jan;19(19):19. doi:10.3390/ijerph191912971\u003c/li\u003e\n\u003cli\u003eSilumbe K, Chiyende E, Finn TP, Desmond M, Puta C, Hamainza B, et al. A qualitative study of perceptions of a mass test and treat campaign in Southern Zambia and potential barriers to effectiveness. Malar J. 2015 Dec;14(1):171. doi:10.1186/s12936-015-0686-3\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Acceptability, Willingness, Malaria, MDA, LaDMA","lastPublishedDoi":"10.21203/rs.3.rs-9192638/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9192638/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eMalaria continues to pose a major public health threat in sub-Saharan Africa, with Ghana accounting for 2.5% of all malaria cases in the region. Mass drug administration (MDA) has emerged as a viable intervention for malaria elimination, yet its success largely depends on community acceptance and adherence, particularly when asymptomatic individuals are required to take antimalarial drugs. The study assessed the willingness of adults in the La Dade-Kotopon Municipality (LaDMA) of Ghana to accept Malaria MDA programs, particularly using dihydroartemisinin-piperaquine (DHAP).\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis study employed a cross-sectional study design involving 421 adults from two communities in LaDMA. Household sampling was used in the selection of participants. A total of 421 households were sampled in the two communities. A structured questionnaire was administered to participants. Acceptability of MDA was assessed using Sekhon et al seven Theoretical Framework of Acceptability (TFA) constructs. Both descriptive and inferential analyses were conducted at an alpha level of 0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean age of the participants was36 years and 57.5% were females. Majority (58.7; 95% CI 54.0\u0026ndash;63.0) of the participants in LaDMA found the malaria MDA program acceptable and will be willing to participate in it. The factors associated with acceptability of the malaria MDA were age (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.001), community (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.004), level of education (p\u0026thinsp;=\u0026thinsp;0.033), occupation (\u003cem\u003ep\u003c/em\u003e =\u0026thinsp;.0.003), monthly income (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.042), religion (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), tribe (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), cultural permissions (p\u0026thinsp;=\u0026thinsp;0.022) and community wellbeing (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Individuals aged 50\u0026ndash;59 years had 66% lower odds of MDA acceptability compared to those aged 18\u0026ndash;29 years (aOR\u0026thinsp;=\u0026thinsp;0.34, 95% CI: 0.11\u0026ndash;0.95, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.040). Those with tertiary education had 72% lower odds of MDA acceptability compared to those with primary education (aOR\u0026thinsp;=\u0026thinsp;0.28, 95% CI: 0.09\u0026ndash;0.86, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.027). Ewes had 68% lower odds of MDA acceptability compared to Gas (aOR\u0026thinsp;=\u0026thinsp;0.32, 95% CI: 0.12\u0026ndash;0.82, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.019)\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWillingness to accept malaria MDA program is moderate. Residents who agreed to participate in MDA programs for purposes of community wellbeing found MDA more acceptable compared to those who disagreed. Emphasizing community-wide benefits may enhance participation in future MDA programs.\u003c/p\u003e","manuscriptTitle":"Willingness to Accept Malaria Mass Drug Administration Using the Theoretical Framework of Acceptability in an Urban Municipality of Ghana: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-14 09:41:16","doi":"10.21203/rs.3.rs-9192638/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-27T05:59:20+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-20T22:16:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-20T16:18:18+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T12:09:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-13T12:58:47+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"134115049012835905197399114425450361004","date":"2026-04-09T22:43:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"91338677123311047006048880808740989861","date":"2026-04-09T17:07:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"288689846857953890879301041692646417205","date":"2026-04-09T08:22:56+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"162541383961841877465420931016375096454","date":"2026-04-07T14:38:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"33826743433786037242620992933414462803","date":"2026-04-07T09:32:53+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-07T06:40:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-07T06:32:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-30T13:26:52+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-30T11:14:35+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-03-30T11:08:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4d6d8c95-ceb1-4f05-8890-d299ceaea3e2","owner":[],"postedDate":"April 14th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-13T17:38:18+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-14 09:41:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9192638","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9192638","identity":"rs-9192638","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}