Assessment of knowledge, attitude, and practices toward malaria in the Lunglei district, Mizoram, North-East India

Abstract Background The western districts of Mizoram (Lunglei, Mamit, and Lawngtlai) are malaria hotspots. The porous boundaries between Mizoram’s western districts and the Chittagong hill tracts of Bangladesh hamper malaria control strategies in the state. Understanding the knowledge, attitudes, and practices of the tribal communities in Mizoram’s western districts will aid the development of specific interventions. Methodology: An explanatory mixed-method study was conducted from April to November 2023 in the Lunglei district. In a community-based cross-sectional survey of 353 participants, the knowledge, attitude, practices, and care-seeking behavior toward malaria were assessed using a semi-structured questionnaire. This was followed by an in-depth telephonic interview of twelve participants, and the data was analyzed in NVivo. Results Out of the 353 respondents, 77.9%, 82.7%, 55.5% and 63.2% of the participants had good knowledge, attitude, practices, and care-seeking behavior, respectively. The responses in the in-depth qualitative interview highlighted the good knowledge about malaria among the villagers in this setting. The respondents were aware of the importance of IRS and insecticide-treated bed nets in malaria control; 11 and 10 respondents (out of 12) were using IRS and insecticide-treated bed nets, respectively. Conclusion The overall good knowledge, attitude, and practices toward malaria among the villagers reflect the strong healthcare system at the grassroots level in Mizoram. For effective dissemination, the Information, Education, and Communication material on malaria could be in the Chakma language as the members of this community were not able to understand and communicate effectively in the local Mizo language. The ecological niche and the agricultural practices, where the villagers are constantly exposed to mosquito bites in the forest greatly facilitate malaria transmission in this region. In addition to vector control measures, active parasite surveillance is key to malaria control in this region.