Zanzibar Malaria Elimination Programme (ZAMEP), Ministry of Health, Zanzibar, United Republic of Tanzania.
The Open University of Tanzania, Dar es Salaam, United Republic of Tanzania.
Malar J. 2023 Feb 2;22(1):39. doi: 10.1186/s12936-023-04472-y.
Zanzibar is among the few places within East Africa that have documented a significant reduction of malaria morbidity and mortality. Despite tremendous gains over the past decade, malaria transmission still persists in Zanzibar. This study aimed at understanding levels of malaria knowledge to provide recommendations that can be used to reinforce and scale up targeted malaria social and behaviour change interventions.
A descriptive cross-sectional survey was conducted through an administered questionnaire to 431 households selected randomly. The interviewees were the heads of household or representative adults above 18 years. This study investigated the levels of knowledge about the causes, symptoms, and prevention of malaria in areas with high (> 1.9 per 1000) and low (< 1 per 1000) incidence of local malaria cases. The Principal Component Analysis (PCA) was used to compute the composite variable of each category. Descriptive statistics were calculated to understand variables of interest between low and high transmission areas. Multinomial logistic regression model was used to compare knowledge on malaria based on key variables.
A total of 431 heads of households were interviewed. Respondent age, education level, and wealth status were significantly associated with variations in level of malaria knowledge. Old age was found to be significantly associated with low knowledge of malaria (P < 0.001). The majority of study participants who had secondary and higher education levels had good knowledge of malaria (P < 0.006). Participants characterized as middle-income had good knowledge compared to those characterized as low-income (P < 0.001).
The study identified existing gaps in malaria knowledge in low and high transmission areas. Low levels of malaria knowledge were documented among elderly and populations with lower education and income levels. There is a need to extend mobilization, advocacy, and expand channels of communication to reach all community members. The reported gaps in knowledge are important to consider when designing strategies to engage communities in malaria elimination in Zanzibar. Tailored social and behavioural change interventions aiming to increase malaria knowledge could enhance the uptake of malaria prevention services in the community.
在东非，桑给巴尔是少数几个记录到疟疾发病率和死亡率显著下降的地方之一。尽管在过去十年中取得了巨大进展，但疟疾在桑给巴尔仍然存在传播。本研究旨在了解疟疾知识水平，提供建议，以加强和扩大有针对性的疟疾社会和行为改变干预措施。
通过对随机选择的 431 户家庭进行问卷调查，进行了一项描述性的横断面研究。受访者为户主或 18 岁以上的代表成年人。本研究调查了在疟疾当地发病率高（>1.9/1000）和低（<1/1000）地区，人们对疟疾病因、症状和预防的知识水平。主成分分析（PCA）用于计算每个类别的综合变量。计算描述性统计数据，以了解低传播区和高传播区之间的感兴趣变量。采用多变量逻辑回归模型比较基于关键变量的疟疾知识。
共访谈了 431 户户主。受访者年龄、教育水平和财富状况与疟疾知识水平的变化显著相关。年龄大与疟疾知识水平低显著相关（P<0.001）。具有中学和高等教育水平的大多数研究参与者对疟疾有较好的了解（P<0.006）。与低收入人群相比，中等收入人群的知识水平较好（P<0.001）。
该研究发现低传播区和高传播区的疟疾知识存在差距。在老年人以及受教育程度和收入水平较低的人群中，疟疾知识水平较低。有必要扩大动员、宣传，并扩大沟通渠道，以覆盖所有社区成员。在设计策略以动员社区参与消除桑给巴尔的疟疾时，需要考虑到这些知识差距。有针对性的社会和行为改变干预措施旨在提高疟疾知识，可以提高社区对疟疾预防服务的接受度。
