Previous Trend, Present Prevalence and Integrated Knowledge, Attitude and Practice Towards Malaria and Use of Insecticide-treated Mosquito Net in the Rural Setting of Welkait District, Northwest Ethiopia

Abstract BackgroundMalaria is still a burden to Ethiopia, especially among the productive ages of the society. Although insecticide-treated mosquito nets (INTs) are widely used by the rural community, malaria remains a leading public health issue. This study aimed to evaluate a 5-year trend, current prevalence and community knowledge, attitude and practice (KAP) towards malaria and use of ITNs as a strategy for prevention of malaria among the rural setting of Welkait district, northwest Ethiopia.MethodsA cross-sectional study was carried out on 403 households to identify the prevalence rate of malaria. Besides, a 5-year (2015-2019) retrospective data was analyzed. Random sampling technique was used to select representative households among the community. Well-structured questionnaire were used to collect KAP data about malaria and utilization of ITNs. Blood samples were collected and examined for identification of malaria parasites using standard microscopic procedure. SPSS version 22 was used for the analysis of the quantitative data. ResultsOf 36,219 outpatients examined, 7,309 (20.2%) malaria-positive cases were reported during 2015-2019. Overall prevalence of malaria continually declined from 2015-2019. Male slide-confirmed (61.4%, N = 4,485) were significantly higher than female (38.6%, N = 2,824) (p < 005). Nineteen (4.7%) confirmed malaria cases were screened during parasitological survey (12 cases of P. falciparum and 7 cases of P. vivax). Most 78.4% (316) and 84.1% (339) of the respondents knew malaria is a communicable and curable disease respectively and 75.6% (239) of them associated it with mosquito bit. From 82.4% (332) respondents who believed malaria is preventable, 81.0% (269) of respondents considered ITNs as the main prevention method. About 64% (257) of the respondents possessed ITNs, of these, 66.9% (172) consistently used ITNs during the peak season. Majority 83.6% (337) of the respondents had a positive attitude towards ITNs. ConclusionsAlthough the retrospective data showed a declining trend of malaria in the district, the current prevalence survey revealed significant increase in malaria infection in the locality. This was due to by unsustainable distribution and inconsistent use of ITNs among the population. We recommend the governments and stockholders to give emphasis on full coverage of ITNs and educate the community about ITNs usage.