Knowledge, attitudes, and practices regarding malaria in rural Uganda: a cross-sectional study

TL;DR

This study explores how knowledge, attitudes, and practices about malaria affect bednet use in rural Uganda, where malaria rates are rising despite high net ownership.

Contribution

The study identifies factors influencing bednet use and links them to recent malaria diagnoses in households.

Findings

High rates of bednet ownership and self-reported use were observed in the study area.

Individuals with a recent household malaria diagnosis reported higher perceived susceptibility and barriers to bednet use.

The association between theoretical constructs and malaria diagnosis remained significant after adjusting for household size.

Abstract

Malaria is endemic in 96% of Uganda, making targeted malaria prevention programming critical to malaria elimination. In areas with low transmission rates prevention resources are limited to mass distribution of bednets every three years. Mosquito nets remain one of the most efficient and affordable malaria prevention strategies. While net distributions have increased net ownership, that has not translated to a comparable increase in net use. The Luwero District is one of two areas with increased rates of severe malaria between 2017-2021. Findings from previous studies indicate that there are a variety of factors associated with individuals choosing not to use a net even when available.

This study examined community members’ knowledge about malaria, their prevention methods, net ownership, net characteristics, and net use. Using a convenience sample of 106 adults, quantitative data were collected using a structured, in-person survey in four villages in central rural Uganda. Questions and response categories were read aloud; the researcher documented each response electronically. Descriptive statistics were used to characterise the sample populations. Theoretical constructs were compared between those with and without a recent diagnosis of malaria with the household. Logistic regression was used to determine the association between the theoretical constructs and recent malaria diagnosis after controlling for demographic characteristics.

Findings from this study indicate high rates of net ownership and self-reported use within the rural areas. Perceived susceptibility and barriers were greater among those with a recent diagnosis of malaria within the household. The positive association remained significant after controlling for household size.

Understanding the specific factors related to individuals' knowledge and use of bednets is key to reducing rates of severe malaria.