Perspectives on community's knowledge, attitude and practices about indoor residual spraying in Kabale District.

Abstract

Introduction: The World Health Organization recommends Indoor Residual Spraying (IRS) as one of the three primary means of malaria control. Two rounds of Mass IRS were conducted in Kabale district in 2006 and 2007 to address the frequent epidemics of malaria in the district. This study assessed community’s Knowledge, Attitudes and Practices on IRS as a malaria control measure in Kabale, with a view to identify gaps and recommend remedial action.

Methodology: This was descriptive cross-sectional study, entailing both quantitative and qualitative methods. The study involved 210 respondents from randomly selected households from three purposively selected sub-counties in Kabale district. Focus Group Discussions and Key Informants were used to corroborate the information from the household interviews. The SPSS programme (version 16.0) was used to conduct logistic regression, univariate and multivariate analysis to establish possible associations between key variables. Qualitative data was summarized and analyzed using content analysis technique based on study issues.

Results: Most of the respondents were adequately knowledgeable and positive about IRS, but did not contribute substantially towards it. There were general fears among the respondents about the safety of the spray chemical used. Statistically significant associations existed between: IRS knowledge level and sex (AOR 4.29, 95% CI 1.37 – 13.41) , respondents’ attitudes towards IRS and knowledge IRS adequacy (OR 36.6, 95% CI 16.1 – 83.3) and respondents’ IRS Contributory practices and age (OR 2.09, 95% CI 1.10 – 4.0). Also significantly associated with contributory actions was house hold size. Households with more people were more likely to contribute towards IRS campaign than those with fewer people. Spray operators had inadequate skills related to mixing of the spray chemical, equipment servicing and maintenance leading to gross chemical wastage and equipment failure.

Conclusions and recommendations: The community members and spray operators are fairly knowledgeable about IRS although critical gaps exist in some aspects. There were general fears about the side effects of spray chemical and inadequate community actions to support the IRS campaign. MoH and local health authorities should institute strategies to increase community IRS knowledge, dispel the myths and clarify their roles in the campaign. Enough spray operators should be trained, adequately equipped and remunerated to motivate them to do a good job.