The variation of malaria prevention measures knowledge and their associated factors: A cross-sectional study in East Nusa Tenggara Province Indonesia

Objective Malaria is one of the major public health problems in African and Southeast Asian countries including Indonesia. However, knowledge of malaria prevention measures (MPM) is not well studied, particularly in Indonesia. This study aimed to investigate the level of MPM knowledge and associated factors among rural adults in high, moderate and low endemic settings of East Nusa Tenggara Province (ENTP) Indonesia. Methods A community-based cross-sectional study was conducted among a randomly selected 1495 households at rural ENTP. Multistage sampling technique was employed to recruit participants. Univariate and multivariable logistic regression model was used to assess factors affecting knowledge of MPM. Results The level of MPM knowledge in low, moderate, and high endemic settings differs significantly with the highest in low settings (57%, 95% CI: 50.5 – 63.5 and the lowest in high settings (19.3%, 95% CI: 11.1 – 27.5). In all settings, good level of MPM knowledge was significantly higher for adults with high SES (Adjusted odds ratio (AOR) = 2.52, 95% CI: 1.20 – 5.30; AOR=20.5,95%CI: 4.64-90.8, AOR=3.31,95%CI: 1.34-8.15 respectively) compared to those having low SES. In high and moderate settings, the likelihood of good MPM knowledge was considerately higher for adults with at least secondary (AOR=2.35, 95% CI= 1.29 – 4.36, AOR=2.66, 95% CI=1.32-5.39 respectively) than those with primary or no education level. Conclusions The good level of MPM knowledge was very low in three different malaria endemic settings. Higher level of education and high SES were significantly associated with the good level. Therefore, health education promotion on MPM knowledge is critical to support malaria elimination program in the province.