A cross-sectional survey on knowledge, attitudes and practices towards malaria control and prevention among caregivers of children under-5 in the Western Area of Sierra Leone

Abstract BackgroundChildren under-5 are the most vulnerable to malaria infection and they suffer serious complications. Sierra Leone is one of the countries with the highest malaria burden in the world. This study aimed to assess the knowledge, attitudes and practices (KAPs) towards malaria control and prevention among caregivers of children under-5 in the Western Area of Sierra Leone.MethodsA cross-sectional survey was conducted among caregivers of children under-5 visiting the out-patient department of six selected hospitals/community health centers. Data were collected via questionnaire interview with 350 caregivers. Further statistical analyses were performed primarily Spearman’s rank test for inferring the correlations among KAPs, univariate and multivariate logistic regression for demonstration the association between KAPs and socio-demographic characteristics.ResultsWomen made up 97.1% of respondents with the majority being young mothers-including 33 single student moms. 46.3% among respondents were unemployed and 27.1% had no educational background. Only 1.4% received malaria related information from the internet/social media. This KAPs survey indicated that misconception of cause, transmission and clinical symptoms of malaria; unawareness of lethality and severity; inappropriate behaviors in prevention and treatment such as self-medicating were still in existence in some caregivers. But a positive correlation in knowledge-attitudes (rs = 0.13, P < 0.05) and attitudes-practices (rs = 0.45, P < 0.001) were revealed. The caregivers being a mother and having at least secondary education were demonstrated associated with positive attitudes and practices. Meanwhile, more urban-based caregivers (79.8%) followed a complete malaria treatment course of ACTs than the rural (63.3%), but in view of ITNs use, more rural-based caregivers presented positive attitudes (85.3%) and practices (70.1%) than the urban (69.9%, 52.0%). The student moms might know more but do less.ConclusionsFor better protection of children under-5 against lethal malaria, providing a better guidance at community level for their caregivers, especially young mothers, is essential to reduce some misconceptions and inappropriate behaviors. It is important to develop an efficient communication channel to disseminate information regarding malaria, especially strengthening community-based media infrastructure, including internet/social media. An increase in education and employment opportunities for women, as well as setting up community-based malaria counselling services, is also needed.