Background
Methods
Study design
Sampling technique
Data collection
Study variables
Dependent variable
Knowledge about causes of malaria
Knowledge about common symptoms of malaria
Knowledge about preventive/protective measures
Independent variables
Statistical analyses
Ethical consideration
Results
Baseline characteristics of the study participants by place of residence
Total sample | Urban | Rural | P-value | |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Age of the respondents | 0.0003 | |||
15–19 | 703 (20.5) | 315 (44.8) | 388 (59.2) | |
20–24 | 694 (20.3) | 340 (49.0) | 354 (51.0) | |
25–29 | 590 (17.2) | 284 (48.1) | 306 (51.9) | |
30–34 | 575 (16.8) | 293 (51.0) | 282 (49.0) | |
35–39 | 436 (12.7) | 212 (48.6) | 224 (51.4) | |
40–49 | 424 (12.3) | 158 (37.3) | 266 (62.7) | |
Highest educational level | <.0001 | |||
No formal education | 252 (7.4) | 52 (20.6) | 200 (79.4) | |
Primary | 1847 (54.0) | 609 (33.0) | 1238 (67.0) | |
Secondary and above | 1323 (38.6) | 941 (71.1) | 382 (28.9) | |
Household has radio | <.0001 | |||
No | 1805 (52.8) | 564 (31.3) | 1241 (68.7) | |
Yes | 1617 (47.2) | 1038 (64.2) | 579 (35.8) | |
Household has television | <.0001 | |||
No | 2442 (71.4) | 768 (31.5) | 1674 (68.5) | |
Yes | 980 (28.6) | 834 (85.1) | 146 (14.9) | |
Sex of household head | 0.0367 | |||
Male | 2514 (73.5) | 1150 (45.7) | 1364 (54.3) | |
Female | 908 (26.5) | 452 (49.8) | 456 (50.2) | |
Wealth index | <.0001 | |||
Poorest/Poorer/Middle | 1169 (34.2) | 42 (3.6) | 1127 (96.4) | |
Richer | 627 (18.3) | 187 (29.8) | 440 (70.2) | |
Richest | 1626 (47.5) | 1373 (84.4) | 253 (15.6) | |
Seen/heard malaria message | 0.0003 | |||
No | 2200 (64.3) | 979 (44.50) | 1221 (55.50) | |
Yes | 1222 (35.7) | 623 (50.98) | 599 (49.02) | |
Ethnicity | <.0001 | |||
Chewa | 977 (28.5) | 426 (43.6) | 551 (56.4) | |
Tumbuka | 751 (22.0) | 347 (46.2) | 404 (53.8) | |
Lomwe | 462 (13.5) | 218 (47.2) | 244 (52.8) | |
Yao | 358 (10.5) | 152 (42.5) | 206 (57.5) | |
Ngoni | 392 (11.5) | 227 (57.9) | 165 (42.1) | |
Other | 482 (14.0) | 232 (48.4) | 250 (51.6) | |
Region | 0.5540 | |||
Northern | 1176 (34.2) | 544 (46.3) | 632 (53.7) | |
Central | 1160 (33.9) | 558 (48.1) | 602 (51.9) | |
Southern | 1086 (53.9) | 500 (46.0) | 582 (54.0) | |
Knowledgea | <.0001 | |||
Low | 972 (28.3) | 335 (34.5) | 637 (65.5) | |
Medium | 748 (21.9) | 337 (45.1) | 411 (54.9) | |
High | 1702 (49.8) | 930 (54.6) | 772 (45.4) |
Causes, symptoms and preventive characteristics of malaria by place of residence
Overall | Urban | Rural | |
---|---|---|---|
n (%) | n (%) | n (%) | |
Causes of malaria | |||
Mosquito bites (Yes) | 3325 (97.2) | 1576 (98.4) | 1749 (96.1) |
Eating immature sugarcane (No) | 3414 (99.8) | 1596 (99.6) | 3414 (99.9) |
Eating cold Nsima (No) | 3404 (99.5) | 1593 (99.4) | 1811 (99.5) |
Eating dirty food (No) | 3333 (97.4) | 1564 (97.6) | 1769 (97.2) |
Drinking dirty water (No) | 3326 (97.3) | 1563 (97.6) | 11,766 (97.0) |
Getting soaked in rain (No) | 3365 (98.3) | 1561 (97.4) | 1804 (99.1) |
Cold or changing weather (No) | 3292 (96.2) | 1545 (46.9) | 1747 (53.1) |
Symptoms of malaria | |||
Fever (Yes) | 2648 (77.4) | 1270 (79.3) | 1378 (75.7) |
Feeling cold (Yes) | 1762 (51.5) | 779 (48.6) | 983 (54.0) |
Headache (Yes) | 2214 (64.7) | 955 (59.6) | 1259 (69.2) |
Nausea and vomiting (Yes) | 1874 (54.8) | 902 (56.3) | 972 (53.4) |
Diarrhea (Yes) | 2589 (75.7) | 1146 (71.5) | 1443 (79.3) |
Dizziness (Yes) | 3335 (97.5) | 1548 (96.6) | 1787 (98.2) |
Loss of appetite (Yes) | 3192 (93.3) | 1435 (89.6) | 1757 (96.5) |
Body ache or joint pain (Yes) | 2029 (59.3) | 918 (57.3) | 1111 (61.0) |
Pale eyes (Yes) | 3342 (97.7) | 1570 (98.0) | 1772 (97.4) |
Salty-tasting palms (Yes) | 3413 (99.7) | 1595 (99.6) | 1818 (99.9) |
Feeling weak (Yes) | 3011 (88.0) | 1390 (86.8) | 1321 (89.1) |
Refuse to eat or drink (Yes) | 3357 (98.1) | 1579 (986) | 1778 (97.7) |
Prevention against malaria | |||
Sleep under a treated net (Yes) | 2209 (64.6) | 1037 (64.7) | 1172 (64.4) |
Sleep under an ITN (Yes) | 1150 (33.6) | 568 (35.5) | 582 (32.0) |
Use mosquito net (Yes) | 3317 (96.9) | 1510 (94.3) | 1807 (99.3) |
Take preventive medication (Yes) | 139 (4.1) | 67 (4.2) | 72 (4.0) |
Spray the house/rooms with insecticide (Yes) | 143 (4.2) | 110 (6.9) | 33 (1.8) |
Clear weeds around the house (Yes) | 356 (10.4) | 168 (10.5) | 188 (10.3) |
Use mosquito coils (Yes) | 3290 (96.1) | 1502 (93.7) | 1788 (98.2) |
Cut grass around house (Yes) | 507 (14.8) | 264 (16.5) | 243 (13.4) |
Fill in stagnant waters (puddles) (Yes) | 758 (22.2) | 432 (27.0) | 326 (17.9) |
Keep surroundings clean (Yes) | 923 (27.0) | 426 (26.6) | 497 (27.3) |
Burn leaves (Yes) | 27 (0.8) | 11 (0.7) | 16 (0.9) |
Avoid drinking dirty water (No) | 3272 (95.6) | 1554 (97.0) | 1718 (94.4) |
Avoid eating bad food (No) | 3342 (97.7) | 1574 (98.3) | 1768 (97.1) |
Put screens on windows (Yes) | 7 (0.2) | 6 (0.4) | 1 (0.1) |
Avoid getting soaked in rain (No) | 3395 (99.2) | 1585(99.9) | 1810 (99.5) |
Characteristics of the study participants by levels of knowledge
Low | Medium | High | P-value | |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Age of the respondents | 0.0002 | |||
15–19 | 242 (34.4) | 160 (22.8) | 301 (42.8) | |
20–24 | 205 (29.5) | 154 (22.2) | 335 (48.3) | |
25–29 | 152 (25.8) | 142 (24.1) | 296 (50.1) | |
30–34 | 151 (26.2) | 128 (22.3) | 296 (51.5) | |
35–39 | 106 (24.3) | 94 (21.6) | 236 (54.1) | |
40–49 | 116 (27.4) | 70 (16.5) | 238 (56.1) | |
Highest educational level | <.0001 | |||
No formal education | 144 (45.3) | 56 (22.2) | 82 (32.5) | |
Primary | 613 (33.2) | 419 (22.7) | 815 (44.1) | |
Secondary and above | 245 (18.5) | 273 (20.6) | 805 (60.9) | |
Household has radio | <.0001 | |||
No | 620 (34.2) | 408 (22.6) | 777 (43.2) | |
Yes | 352 (21.8) | 340 (21.0) | 925 (57.2) | |
Household has television | <.0001 | |||
No | 807 (33.1) | 548 (22.4) | 1087 (44.5) | |
Yes | 165 (16.9) | 200 (20.4) | 615 (62.8) | |
Sex of household head | 0.9604 | |||
Male | 717 (28.5) | 550 (21.9) | 1247 (49.6) | |
Female | 255 (28.1) | 198 (21.8) | 455 (50.1) | |
Wealth index | <.0001 | |||
Poorest/Poorer/Middle | 463 (39.6) | 275 (23.5) | 431 (36.9) | |
Richer | 183 (29.2) | 136 (21.7) | 308 (49.1) | |
Richest | 326 (20.1) | 337 (20.7) | 963 (59.2) | |
Seen/heard malaria message | <.0001 | |||
No | 717 (32.6) | 497 (22.6) | 986 (44.8) | |
Yes | 255 (20.9) | 251 (20.5) | 716 (58.6) | |
Ethnicity | <.0001 | |||
Chewa | 327 (33.5) | 219 (22.4) | 431 (44.1) | |
Tumbuka | 189 (25.2) | 138 (18.4) | 424 (56.5) | |
Lomwe | 116 (25.1) | 115 (24.9) | 231 (50.0) | |
Yao | 133 (37.2) | 84 (23.5) | 141 (39.4) | |
Ngoni | 89 (22.7) | 94 (24.0) | 209 (53.3) | |
Other | 118 (24.5) | 98 (20.3) | 266 (55.2) | |
Place of residence | <.0001 | |||
Urban | 335 (20.9) | 337 (21.0) | 930 (58.1) | |
Rural | 637 (35.0) | 411 (22.6) | 772 (42.4) | |
Region | 0.0001 | |||
Northern | 294 (25.0) | 233 (19.8) | 649 (55.2) | |
Central | 358 (30.9) | 253 (21.8) | 549 (47.3) | |
Southern | 320 (29.5) | 262 (24.1) | 504 (46.4) |
Characteristics of the study participants by educational level
Characteristics | No education | Primary education | Secondary and above education | P-value |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Age of the respondents | <.0001 | |||
15–19 | 13 (1.85) | 400 (56.90) | 290 (41.25) | |
20–24 | 29 (4.18) | 336 (48.41) | 329 (47.41) | |
25–29 | 29 (4.92) | 308 (52.20) | 253 (42.88) | |
30–34 | 43 (7.48) | 311 (54.09) | 221 (38.43) | |
35–39 | 44 (10.09) | 253 (58.03) | 139 (31.88) | |
40–49 | 94 (22.17) | 239 (56.37) | 91 (21.46) | |
Household has radio | <.0001 | |||
No | 182 (72.22) | 1145 (61.99) | 478 (36.13) | |
Yes | 70 (27.78) | 702 (38.01) | 845 (63.87) | |
Household has television | <.0001 | |||
No | 240 (95.24) | 1573 (85.17) | 629 (47.54) | |
Yes | 12 (4.76) | 274 (14.83) | 694 (52.46) | |
Wealth index† | <.0001 | |||
Poorest/Poorer/Middle | 167 (66.27) | 866 (46.89) | 136 (10.28) | |
Richer | 52 (20.63) | 403 (21.82) | 172 (13.00) | |
Richest | 33 (13.10) | 578 (31.29) | 1015 (76.72) | |
Seen/heard malaria message | <.0001 | |||
No | 207 (82.14) | 1293 (70.01) | 700 (52.91) | |
Yes | 45 (17.86) | 554 (29.99) | 623 (47.09) | |
Ethnicity | <.0001 | |||
Chewa | 104 (41.27) | 538 (29.13) | 335 (25.32) | |
Tumbuka | 14 (5.56) | 363 (19.65) | 374 (28.27) | |
Lomwe | 28 (11.11) | 270 (14.62) | 164 (12.40) | |
Yao | 43 (17.06) | 224 (12.13) | 91 (6.88) | |
Ngoni | 25 (9.92) | 194 (10.50) | 173 (13.08) | |
Other | 38 (15.08) | 258 (13.97) | 186 (14.06) | |
Place of residence | <.0001 | |||
Urban | 52 (20.63) | 609 (32.97) | 941 (71.13) | |
Rural | 200 (79.37) | 1248 (67.03) | 382 (28.87) | |
Geographical region | <.0001 | |||
Northern | 37 (14.68) | 590 (31.94) | 549 (41.50) | |
Central | 109 (43.25) | 648 (35.09) | 403 (30.46) | |
Southern | 106 (42.06) | 609 (32.97) | 371 (28.04) |
Characteristics of the study participants by pregnancy status
Total sample | Non-pregnant | Pregnant | P-value | |
---|---|---|---|---|
n (%) | n (%) | n (%) | ||
Age of the respondents | <.0001 | |||
15–19 | 703 (20.5) | 670 (20.9) | 33 (15.0) | |
20–24 | 694 (20.3) | 620 (19.4) | 74 (33.8) | |
25–29 | 590 (17.2) | 543 (17.0) | 47 (21.5) | |
30–34 | 575 (16.8) | 530 (16.6) | 45 (20.6) | |
35–39 | 436 (12.7) | 419 (13.1) | 17 (7.8) | |
40–49 | 424 (12.39) | 421 (13.1) | 3 (1.4) | |
Highest educational level | 0.0315 | |||
No formal education | 252 (7.4) | 244 (7.6) | 8 (3.7) | |
Primary | 1847 (54.0) | 1714 (53.5) | 133 (60.7) | |
Secondary and above | 1323 (38.7) | 1245 (38.9) | 78 (35.6) | |
Household has radio | 0.6259 | |||
No | 1805 (52.75) | 1686 (52.64) | 119 (54.3) | |
Yes | 1617 (47.3) | 1517 (47.3) | 100 (45.7) | |
Household has television | 0.0494 | |||
No | 2442 (71.4) | 2273 (71.0) | 169 (77.2) | |
Yes | 980 (28.6) | 930 (29.0) | 50 (22.8) | |
Sex of household head | <.0001 | |||
Male | 2514 (73.5) | 2327 (72.7) | 187 (85.4) | |
Female | 908 (26.5) | 876 (27.3) | 32 (14.6) | |
Wealth index | 0.0042 | |||
Poorest/Poorer/Middle | 1169 (34.2) | 1073 (33.5) | 96 (43.8) | |
Richer | 627 (18.3) | 587 (18.3) | 40 (18.3) | |
Richest | 1626 (47.5) | 1543 (48.2) | 83 (37.9) | |
Seen/heard malaria message | 0.0213 | |||
No | 2200 (64.3) | 2075 (64.8) | 125 (57.1) | |
Yes | 1222 (35.7) | 1128 (35.2) | 94 (42.9) | |
Ethnicity | 0.6892 | |||
Chewa | 977 (28.6) | 909 (28.4) | 68 (31.1) | |
Tumbuka | 751 (22.0) | 703 (22.0) | 48 (21.9) | |
Lomwe | 462 (13.5) | 428 (13.4) | 34 (15.5) | |
Yao | 358 (10.5) | 336 (10.5) | 22 (10.1) | |
Ngoni | 392 (11.5) | 369 (11.5) | 23 (10.5) | |
Other | 482 (14.1) | 458 (14.3) | 24 (11.0) | |
Place of residence | 0.0026 | |||
Urban | 1602 (46.8) | 1521 (47.5) | 81 (37.0) | |
Rural | 1820 (56.2) | 1682 (52.5) | 138 (63.) | |
Region | 0.6803 | |||
Northern | 1176 (34.4) | 1105 (34.5) | 71 (32.4) | |
Central | 1160 (33.9) | 1080 (33.7) | 80 (36.5) | |
Southern | 1086 (54.0) | 1018 (31.8) | 68 (31.1) | |
Knowledgea | 0.7980 | |||
Low | 979 (28.6) | 915 (28.6) | 64 (29.2) | |
Medium | 1358 (39.7) | 1268 (39.6) | 90 (41.1) | |
High | 1085 (31.7) | 1020 (31.9) | 65 (29.7) |
Factors associated with the levels of knowledge related to the causes, symptoms and preventive measures of malaria: low versus high knowledge
Low vs high knowledge | P-value | Medium vs high knowledge | P-value | Knowledge scorec | P-value | |
---|---|---|---|---|---|---|
AOR 95% (CI) | AOR 95% (CI) | β (SE) | ||||
Maternal age (years) | ||||||
15–19 | 2.58 (1.69–3.92) | <.0001 | 2.03 (1.37–3.03) | 0.0006 | − 0.73 (0.12) | <.0001 |
20–24 | 1.84 (1.19–2.84) | 0.0064 | 1.78 (1.15–2.78) | 0.0107 | − 0.61 (0.12) | <.0001 |
25–29 | 1.45 (0.96–2.21) | 0.0791 | 1.92 (1.30–2.84) | 0.0012 | − 0.39 (0.12) | 0.0017 |
30–34 | 1.29 (0.82–2.03) | 0.2713 | 1.48 (0.95–2.29) | 0.0816 | − 0.27 (0.12) | 0.0300 |
35–39 | 1.17 (0.79–1.74) | 0.4382 | 1.39 (0.83–2.38) | 0.2031 | − 0.24 (0.13) | 0.0728 |
40–49 | 1.00 | 1.00 | 1.00 | |||
Highest educational level | ||||||
No education | 3.73 (2.20–6.33) | <.0001 | 1.98 (1.25–3.14) | 0.0041 | − 1.17 (0.15) | <.0001 |
Primary | 2.02 (1.51–2.70) | <.0001 | 1.39 (1.04–1.86) | 0.0274 | − 0.65 (0.08) | <.0001 |
Secondary and above | 1.00 | 1.00 | 1.00 | |||
Household has radio | ||||||
No | 1.14 (0.85–1.54) | 0.3845 | 0.99 (0.76–1.28) | 0.9271 | − 0.15 (0.0816) | 0.0715 |
Yes | 1.00 | 1.00 | 1.00 | |||
Household has television | ||||||
No | 1.50 (1.02–2.22) | 0.0393 | 1.079 (0.75–1.56) | 0.6830 | − 0.12 (0.1035) | 0.2578 |
Yes | 1.00 | 1.00 | 1.00 | |||
Wealth indexb | ||||||
Poorest/Poorer/Middle | 1.20 (0.70–2.04) | 0.5078 | 1.101 (0.68–1.78) | 0.6919 | − 0.14 (0.1371) | 0.2995 |
Richer | 0.87 (0.56–1.35) | 0.5266 | 0.916 (0.58–1.44) | 0.7024 | − 0.02 (0.1217) | 0.8562 |
Richest | 1.00 | 1.00 | 1.00 | |||
Seen/heard malaria message | ||||||
No | 1.53 (1.20–1.95) | 0.0008 | 1.23 (0.92–1.66) | 0.1667 | − 0.41 (0.07) | <.0001 |
Yes | 1.00 | 1.00 | 1.00 | |||
Ethnicity | ||||||
Chewa | 1.51 (0.90–2.54) | 0.1212 | 1.14 (0.70–1.874) | 0.5953 | − 0.10 (0.14) | 0.4465 |
Tumbuka | 0.84 (0.52–1.37) | 0.4876 | 0.94 (0.56–1.595) | 0.8266 | − 0.05 (0.14) | 0.7381 |
Lomwe | 0.94 (0.56–1.60) | 0.9619 | 1.19 (0.76–1.864) | 0.4505 | 0.03 (0.15) | 0.8256 |
Yao | 1.95 (1.10–3.46) | 0.0219 | 1.30 (0.81–2.069) | 0.2695 | 0.01 (0.17) | 0.9700 |
Ngoni | 0.85 (0.47–1.54) | 0.5937 | 0.99 (0.63–1.56) | 0.9604 | − 0.05 (0.16) | 0.7407 |
Other | 1.00 | 1.00 | 1.00 | |||
Place of residence | ||||||
Urban | 0.57 (0.36–0.92) | 0.0228 | 0.64 (0.41–0.93) | 0.0205 | 0.22 (0.17) | 0.1780 |
Rural | 1.00 | 1.00 | 1.00 | |||
Geographical region | ||||||
Northern | 0.77 (0.50–1.17) | 0.2175 | 0.63 (0.40–0.99) | 0.0438 | 0.30 (0.20) | 0.1297 |
Central | 0.87 (0.56–1.34) | 0.5173 | 0.80 (0.55–1.16) | 0.2365 | 0.04 (0.19) | 0.8091 |
Southern | 1.00 | 1.00 | 1.00 |