Treatment seeking behaviors.

BackgroundIn sub-Saharan Africa countries including Ghana, the malaria burden remains unacceptably high and still a serious health challenge. Evaluating a community’s level of knowledge, attitude, and practice (KAP) regarding malaria is essential to enabling appropriate preventive and control measures. This study aimed to evaluate knowledge of malaria, attitudes toward the disease, and adoption of control and prevention practices in some communities across the Eastern Region of Ghana.MethodsA cross‑sectional based study was carried out in 13 communities across 8 districts from January -June, 2020. Complete data on socio-demographic characteristics and KAP were obtained from 316 randomly selected household respondents by a structured pre-tested questionnaire. Associations between KAP scores and socio-demographic profiles were tested by Chi-square and binary logistic regression. Data analysis was done with SPSS version 26.0.ResultsMost respondents (85.4%) had good knowledge score about malaria. Preferred choice of treatment seeking place (50.6%) was the health center/clinic. All respondents indicated they would seek treatment within 24 hours. Mosquito coils were the preferred choice (58.9%) against mosquito bites. Majority of households (58.5%) had no bed nets and bed net usage was poor (10.1%). Nearly half of the respondents (49.4%) had a positive attitude toward malaria and 40.5% showed good practices. Chi-square analysis showed significant associations for gender and attitude scores (p = 0.033), and educational status and practice scores (p = 0.023). Binary logistic regression analysis showed that 51–60 year-olds were less likely to have good knowledge (OR = 0.20, p = 0.04) than 15–20 year-olds. Respondents with complete basic schooling were less likely to have good knowledge (OR = 0.33, p = 0.04) than those with no formal schooling. A positive attitude was less likely in men (OR = 0.61, p = 0.04). Good malaria prevention practice was lower (OR = 0.30, p = 0.01) in participants with incomplete basic school education compared to those with no formal schooling.ConclusionOverall scores for respondents’ knowledge, though good, was not reflected in attitudes and levels of practice regarding malaria control and prevention. Behavioral change communication, preferably on radio, should be aimed at attitudes and practice toward the disease.背景 在包括加纳在内的撒哈拉以南非洲国家，疟疾负担仍高得令人无法接受，仍是严峻的公共卫生挑战。评估社区人群对疟疾的知识、态度与行为（Knowledge, Attitude, Practice, KAP）水平，对于制定恰当的疟疾预防与控制措施至关重要。本研究旨在评估加纳东部地区部分社区居民的疟疾认知情况、对该疾病的态度，以及疟疾防控实践的落实情况。 方法 本研究于2020年1月至6月在8个区县的13个社区开展横断面研究。研究人员通过经过预试验的结构化问卷，从316名随机选取的家庭受访者中收集了社会人口学特征及KAP相关的完整数据。采用卡方检验与二元logistic回归分析，检验KAP得分与社会人口学特征之间的关联。数据分析使用SPSS 26.0软件完成。 结果 多数受访者（85.4%）的疟疾认知得分良好。50.6%的受访者首选就医地点为卫生中心/诊所。所有受访者均表示会在24小时内就医。58.9%的受访者首选使用蚊香来预防蚊虫叮咬。多数家庭（58.5%）未配备蚊帐，且蚊帐使用率仅为10.1%，情况不佳。近半数受访者（49.4%）对疟疾持有积极态度，40.5%的受访者防控行为表现良好。卡方分析显示，性别与态度得分（p=0.033）、受教育程度与行为得分（p=0.023）之间存在显著关联。二元logistic回归分析显示，与15~20岁年龄段人群相比，51~60岁人群拥有良好疟疾认知的可能性更低（比值比（Odds Ratio, OR）=0.20，p=0.04）。与未接受过正规教育的人群相比，完成基础学业的人群拥有良好疟疾认知的可能性更低（OR=0.33，p=0.04）。男性持有积极态度的可能性更低（OR=0.61，p=0.04）。与未接受过正规教育的人群相比，未完成基础学业的参与者的疟疾预防行为达标率更低（OR=0.30，p=0.01）。 结论 尽管受访者的整体疟疾认知得分良好，但这并未体现在其对疟疾防控的态度与行为水平上。应针对人群对疟疾的态度与行为开展行为改变沟通活动，优先通过广播渠道进行。