Malaria Prevention and Mothers: Sudan

(Yousif M. Elmosaad, Ahmed M Al Rajeh, Asif khan, Elfatih M. Malik and Ilias Mahmud)

---

Abstract

This study assessed the knowledge, attitudes, and practices (KAP) in malaria prevention using insecticide-treated bed nets (ITNs) among mothers of children under five years of age in White Nile State, Sudan. Multistage cluster sampling was used to select 761 mothers for this cross-sectional survey. There were gaps in the KAP in malaria prevention. Only 46.3% of the mothers stated personal protective measures (PPMs) as the best malaria prevention strategy; 54.9% considered ITNs as an effective means; and only 18.7% reported sleeping under an ITN every day. Older mothers were less likely to have good knowledge (OR=0.96), attitudes (OR=0.98) and practices (OR=0.98). Having a Government employee as the head of the household was positively associated with knowledge (OR=2.16) and attitudes (OR=1.96). The mother having a formal education was also positively associated with good knowledge (OR=1.55) and positive attitudes (OR=1.69). Mothers with a monthly household income of <491 Sudanese Pound were more likely to have good knowledge (OR=1.43). Mothers who had good knowledge (OR=4.99) and positive attitudes towards PPMs (OR=2.60) in malaria prevention were found to be more likely to practice preventive measures. Therefore, we recommend focusing on raising mothers’ awareness of the different preventive activities to protect them and their family from malaria. 

KEYWORDS
Perceptions, practices, control, treatment, under-five children

PDF

References

Abate, A., Degarege, A. and Erko, B. (2013). Community knowledge, attitude and practice about malaria in a low endemic setting of Shewa Robit Town, northeastern Ethiopia. BMC public health, 13(1), 312–20. 
Ahmed, S.M., Haque, R., Haque, U. and Hossain, A., (2009). Knowledge on the transmission, prevention and treatment of malaria among two endemic populations of Bangladesh and their health-seeking behaviour. Malaria journal, 8(1), 173–174.
Atulomah, E.T., Farotimi, A.A. and Atulomah, N.O. (2014). Knowledge, Attitude and Practice of Malaria Prevention among Expectant Mothers attending Ante-Natal Clinic at OOUTH Sagamu, Ogun State. ActaSATECH, 5(1), 9–25.
Aung, T., Wei, C., McFarland, W., Aung, Y.K. and Khin, H.S.S. (2016). Ownership and use of insecticide-treated nets among people living in malaria endemic areas of Eastern Myanmar. PLoS One, 11(9), p.e0162292.
Chukwurah, J.N., Idowu, E.T., Adeneye, A.K., Aina, O.O., Agomo, P.U. and Otubanjo, A.O. (2016). Knowledge, attitude and practice on malaria prevention and sulfadoxine-pyrimethamine utilisation among pregnant women in Badagry, Lagos State, Nigeria. Studies, 7(3), 9–10.
Dawaki, S., Al-Mekhlafi, H.M., Ithoi, I., Ibrahim, J., Atroosh, W.M., Abdulsalam, A.M., Sady, H., Elyana, F.N., Adamu, A.U., Yelwa, S.I. and Ahmed, A. (2016). Is Nigeria winning the battle against malaria? Prevalence, risk factors and KAP assessment among Hausa communities in Kano State. Malaria journal, 15(1), 351–65.  
Elfaki, A.E.M., Elnimeiri, M.K.M. and Elfakey, W.E.M. (2017), Attitude Towards Malaria in Under-Five Years Children: A Study From Blue Nile State, Sudan. IOSR Journal of Dental and Medical Sciences, 16(11), 71–5.
Elmosaad, Y.M., Elhadi, M., Khan, A., Malik, E.M. and Mahmud, I. (2016). Communication for behavioural impact in enhancing utilization of insecticide-treated bed nets among mothers of under-five children in rural North Sudan: an experimental study. Malaria Journal, 15(1), 509–15.
El-Rayah, E.A., Giha, H.A. and El-Feki, A.E.K.A. (2009). Knowledge, practices and perceptions which affect acquiring malaria in man-made malarious area in Khartoum State, Sudan. Sudan. Sudanese J Public Health, 4(1), 199–209.
Federal Ministry of Health. (2016). Malaria indicator survey, Northern states of the Sudan. Khartoum: Baseline results at household level. Malaria journal, 13(1), 45. 
Fegan, G.W., Noor, A.M., Akhwale, W.S., Cousens, S. and Snow, R.W. (2007). Effect of expanded insecticide-treated bed net coverage on child survival in rural Kenya: A longitudinal study. The Lancet, 370(9592), 1035–9.
Forero, D.A., Chaparro, P.E., Vallejo, A.F., Benavides, Y., Gutiérrez, J.B., Arévalo-Herrera, M. and Herrera, S. (2014). Knowledge, attitudes and practices of malaria in Colombia. Malaria Journal, 13(1), 165–175. 
Fuge, T.G., Ayanto, S.Y. and Gurmamo, F.L. (2015). Assessment of knowledge, attitude and practice about malaria and ITNs utilization among pregnant women in Shashogo District, Southern Ethiopia. Malaria Journal, 14(1), 235–44.
Habimana, A., Harerimana, A., Asingizwe, D., Nyandwi, T. and Njunwa, K.J. (2016). Community Health Workers’ knowledge, attitudes and practices about malaria prevention in Gicumbi District, Rwanda. Rwanda Journal, 3(1), 27–35.
Hanafi-Bojd, A.A., Vatandoost, H., Oshaghi, M.A., Eshraghian, M.R., Haghdoost, A.A., Abedi, F., Zamani, G., Sedaghat, M.M., Rashidian, A., Madani, A.H. and Raeisi, A. (2011). Knowledge, attitudes and practices regarding malaria control in an endemic area of southern Iran. Southeast Asian Journal of Tropical Medicine and Public Health, 42(3), 491–501.
Hlongwana, K.W., Mabaso, M.L., Kunene, S., Govender, D. and Maharaj, R. (2009). Community knowledge, attitudes and practices (KAP) on malaria in Swaziland: a country earmarked for malaria elimination. Malaria journal, 8(1), 29–36. 
Israel, G.D. (1992). Sampling the Evidence of Extension Program Impact. Gainesville, FL: University of Florida Cooperative Extension Service, Institute of Food and Agriculture Sciences, EDIS.
Joshi, A.B. and Banjara, M.R. (2008). Malaria related knowledge, practices and behaviour of people in Nepal. Journal of Vector Borne Diseases, 45(1), 44–52. 
Khairy, S., Al-Surimi, K., Ali, A., Shubily, H.M., Al Walaan, N., Househ, M. and El-Metwally, A. (2017). Knowledge, attitude and practice about malaria in South-Western Saudi Arabia: A household-based cross-sectional survey. Journal of Infection and Public Health, 10(5), 499–506.
Kimbi, H.K., Nkesa, S.B., Ndamukong-Nyanga, J.L., Sumbele, I.U., Atashili, J. and Atanga, M.B. (2014). Knowledge and perceptions towards malaria prevention among vulnerable groups in the Buea Health District, Cameroon. BMC Public Health, 14(1), 883–92.
Lengeler, C., 2004. Insecticide‐treated bed nets and curtains for preventing malaria. Cochrane Database of Systematic Reviews, 2(n/a), n/a, CD000363. doi: 10.1002/14651858.CD000363.pub2. 
Manana, P.N., Kuonza, L., Musekiwa, A., Mpangane, H.D. and Koekemoer, L.L. (2018). Knowledge, attitudes and practices on malaria transmission in Mamfene, KwaZulu-Natal Province, South Africa 2015. BMC Public Health, 18(1), 1–7.
Musoke, D., Karani, G., Ndejjo, R., Okui, P. and Musoke, M.B. (2016). Experiences of households using integrated malaria prevention in two rural communities in Wakiso district, Uganda: a qualitative study. Malaria Journal, 15(1), 1-9.
Ndwiga, T., Kei, R.M. and Dancan, O.W., 2014. Utilization of insecticide treated bed nets among mothers attending MCH/FP in Webuye District Hospital, Bungoma County, Kenya. Open Journal of Preventive Medicine, 4(n/a), 470–80.
OCHA (2020). Sudan Situation Report 12 December 2019. Geneva; 2019. Available at: https://reliefweb.int/sites/reliefweb.int/files/resources/Situation (accessed on 23/03/2020).
Oyekale, A.S. (2015). Assessment of Malawian mothers’ malaria knowledge, healthcare preferences and timeliness of seeking fever treatments for children under five years. International Journal of Environmental Research and Public Health, 12(1), 521–40.
Ruberto, I., Camara, S., Banek, K. and Loua, M.K. (2014). Knowledge, attitudes and practices of malaria control among communities from the health district of Forécariah in the Republic of Guinea, West Africa. Journal of Vector Borne Diseases, 51(2), 119–27.
Sanjana, P., Barcus, M.J., Bangs, M.J., Ompusunggu, S., Elyazar, I., Marwoto, H., Tuti, S., Sururi, M., Tjokrosonto, S. and Baird, J.K. (2006). Survey of community knowledge, attitudes and practices during a malaria epidemic in central Java, Indonesia. The American Journal of Tropical Medicine and Hygiene, 75(5), 783–89.
Schumacher, R.F. and Spinelli, E. (2012). Malaria in children. Mediterranean journal of hematology and infectious diseases, 4(1), n/a, e2012073, DOI: 10.4084/MJHID.2012.073.
Shimaponda-Mataa, N.M., Tembo-Mwase, E., Gebreslasie, M. and Mukaratirwa, S. (2017). Knowledge, attitudes and practices in the control and prevention of malaria in four endemic provinces of Zambia. Southern African Journal of Infectious Diseases, 32(1), 29-39.
Singh, M., Brown, G. and Rogerson, S.J. (2013). Ownership and use of insecticide-treated nets during pregnancy in sub-Saharan Africa: a review. Malaria Journal, 12(1), 268–78. 
Singh, R., Musa, J., Singh, S. and Ebere, U.V. (2014). Knowledge, attitude and practices on malaria among the rural communities in Aliero, Northern Nigeria. Journal of Family Medicine and Primary Care, 3(1), 39–49.
SMOH. White Nile state Ministry of Health Kosti. (2012). Available at: https://reliefweb.int/report/sudan/sudan-report-health (accessed on 25/03/2019)
Soleimani-Ahmadi, M., Vatandoost, H., Zare, M., Alizadeh, A. and Salehi, M. (2014). Community knowledge and practices regarding malaria and long-lasting insecticidal nets during malaria elimination programme in an endemic area in Iran. Malaria Journal, 13(1), 1–7.
Tayseir T. M. Masaad, Yousif M. Elmosaad, Mohammed AEE, Elmanssury AE, Jaber M, M.Mustafa and Edrees, H., M. (2017). Knowledge, attitude and practices among mothers towards insecticide-treated nets in Abuharira Village -UmRemta Locality- the White Nile State -2015. Science Journal of Clinical Medicine, 6(2), 24–31. 
World Health Organization. (2011). World Malaria Report 2011. Geneva: World Health Organization.
World Health Organization. (2015). World Malaria Report 2014: Summary (No. WHO/HTM/GMP/2015.2). World Health Organization
World Health Organization. (2017). World Malaria Report 2015. Geneva: World Health Organization; 2015. Fecha De Consulta, 23(n/a), 238–39.
World Health Organization. (2018). World Malaria Report 2018. Geneva: World Health Organization. Licence: CC BY-NC-SA, 3.
World Health Organization. (2019). The Selection And Use Of Essential Medicines: Report Of The WHO Expert Committee On Selection And Use Of Essential Medicines, 2019 (Including The 21st WHO Model List Of Essential Medicines And The 7th WHO Model List Of Essential Medicines For Children). Geneva: World Health Organization
Yaya, S., Bishwajit, G., Ekholuenetale, M., Shah, V., Kadio, B. and Udenigwe, O. (2017). Knowledge of prevention, cause, symptom and practices of malaria among women in Burkina Faso. PLoS One, 12(7), p.e0180508.