Knowledge, perceptions, and practices on indoor residual spraying acceptance for malaria prevention in Dokolo district

Abstract

An estimated 3.4 billion people globally, are at risk of being infected with malaria and developing the disease, with children under five years being the most vulnerable, accounting for 67% of all the malaria deaths globally. Sub-Saharan Africa remains the most affected region globally, accounting for 93% of all malaria cases and 94% of all malaria deaths in all age groups worldwide. Uganda is ranked third among the top African countries that accounted for more than half of all malaria cases worldwide, contributing 5% of the Global Malaria burden alone Vector control with Indoor residual spraying (IRS) is one of the key interventions for global malaria control and elimination. Communities’ knowledge and perceptions of IRS programme for malaria control varies. Addressing these knowledge gap is essential in demystifying misperceptions and filling the knowledge gap to ensure responsiveness and increase community’s uptake of IRS as a malaria control intervention. The aim of this study was therefore to assess the level of knowledge and perception on indoor residual spraying as a vector control intervention for malaria transmission in Dokolo district Methodology: A cross-sectional household survey was conducted in Dokolo District, from August to September, 2022. A total of 205 households were involved in the study. Both and quantitative and qualitative data was collected using pre-tested semi-structured questionnaire, key informant interview guide and focused group discussion guides. A multistage sampling and purposive sampling methods were used to select participants for the quantitative and qualitative studies, respectively. The primary focus of interest were knowledge, and perception that were analysed separately. Quantitative data collected were edited, coded, entered, and analysed using SPSS statistical software. Results were summarised using frequency tables, standard deviations, and

medians. Bivariate and multivariate analysis were conducted to study association between the variables of interest, and other variables known to affect the dependent variables using a modified poisson regression model to determine knowledge, and perception Results: This study shows that 86.3% (117/205) of respondents were knowledgeable about malaria transmission with the major source of information 61% (125/205) coming from the health facilities. From the households visited, 91.2 % (187/205) had sprayed their houses, while 2.9 % (6/205) had not. Out of those who had not sprayed their houses, 26.3% (10/38) believed that spraying was not effective against mosquitoes, while 15.7% (6/38) believed that the chemical was harmful to their health, and 26.3% (10/38) of the respondents did not believe that IRS is effective in malaria control and were not willing to it take-up. Households of respondents who were formally employed and owning any form of business were more likely to be unsprayed; (APR=5.81, CI=2.72- 12.68); (APR= 3.84, CI=1.20-12.31) respectively. Conclusions:

The study found that the community had adequate knowledge about IRS. This knowledge could be the predictor for high IRS coverage and acceptance. Negative perceptions about IRS and limited knowledge were prominent especially among the rural and less educated individuals, with smell of insecticides, lack of trust in effectiveness of insecticides, and fear that the insecticides could be harmful to their health being the major factors for negative perceptions.