Community knowledge and perceptions about malaria and practices influencing malaria control in Mpumalanga Province, South Africa

Objective. To assess community knowledge and perceptions about malaria and its control in a rural setting. Design. Descriptive cross-sectional survey. Setting. Tonga district with a population of 116 418, seasonal malaria with an annual incidence of 3 200 cases. Subjects. Female heads of 299 randomly selected households. Methodology. A total of 299 households were selected from a random sample o f 30 clusters. Community knowledge and perceptions about malaria and its co ntrol were assessed by interviews with the female head of each of the 299 s elected households. Results. Respondents ranked malaria as the third most serious health proble m facing the community after TB and AIDS. Seventy-two per cent (214/299) of respondents reported that they knew what malaria disease was and of these, 92.1% (197/214) mentioned mosquito bites as the cause of malaria. The resp ondents' understanding of the causal role of mosquitoes in malaria was sign ificantly related to their knowledge about disease symptoms (P < 0.001). Re ported community compliance with the malaria control programme (MCP) was sa tisfactory; 86.6% (259/299) of respondents reported that their homes had be en sprayed during the past 2 years but 10.0% (30/299) did not know why home s were sprayed. Hospitals or clinics were the facilities where respondents most commonly sought treatment for fever; 66.9% (200/299) reported that the y would seek treatment immediately after the onset of high fever. Specific practices such as replastering or washing of inside walls compromised the e ffectiveness of the MCP. Personal preventive measures were sometimes used a gainst malaria (50.8%, 152/299) and use was positively associated with educ ation level (P = 0.001). Respondents expressed their desire,for more inform ation about malaria and their willingness to contribute to the control of m alaria in their community. Conclusion. The survey collected information which was directly relevant to the development of health education messages to increase community awarene ss of the problem of malaria, to emphasise the importance of early diagnosi s and prompt treatment of malaria, to Improve community understanding of th e function of indoor residual spraying, and to enlighten the population of the role of mosquitoes in malaria transmission and the availability and ben efits of personal protection measures against mosquito bites.