Women's knowledge and perceptions of malaria and use of malaria vector control interventions in Kersa, eastern Ethiopia

Background: Ethiopia has a long history of controlling malaria using vector control tools. Community knowledge and perceptions of malaria and use of malaria vector control interventions vary. Objective: The aim of this study was to determine malaria-related knowledge and perceptions among women and to determine the use of malaria vector control interventions, mainly indoor residual spraying (IRS) and insecticide-treated nets (ITNs), among households in Kersa, Eastern Ethiopia. Design: A cross-sectional survey was conducted in Kersa Demographic Surveillance and Health Research Center (KDS-HRC) site from October to November 2010. A total of 2,867 households were involved in the study. The data was collected via face-to-face interviews with the women of the household using a pre-tested questionnaire. The questionnaire contained closed, semiclosed, and open-ended questions to explore the reasons for non-use of the interventions. Each knowledge, perception, and practice question was analyzed separately. Results: Of the total women, 2,463 (85.9%) had heard of malaria. Of them, 1,413 (57.4%) mentioned malaria as a communicable disease. But, only 793 (56.1%) of them associated mosquito bites with malaria transmission. Seven hundred and ninety-eight of the respondents (27.8%) had IRS coverage, and of these, 59 (7.4%) had re-plastered their interior walls following the application of insecticides. Of net-owning households, 33.5% had used at least one long-lasting insecticide-treated net (LLIN) the night before the survey. Societal reasons such as holy days and dislike of the insecticide mainly due to fear of its effects on their livestock, were the main reasons for re-spondents replastering their walls. Conclusions: A substantial number of women had heard about malaria, but there was a knowledge gap regarding the route of malaria transmission. Less than one-third of the surveyed household houses were sprayed with insecticides, and a low proportion of net-owning households actually used their nets. Efforts must be made to ensure the correct channeling of information about malaria, particularly regarding the importance of using malaria vector control interventions. Furthermore, to maximize the benefit of the intervention in the district, IRC coverage and LLIN use need to be stronger.