KNOWLEDGE, PERCEPTION, EXPERIENCES AND PRACTICES RELATING TO MALARIA AND INSECTICIDE-TREATED NETS AMONG PREGNANT WOMEN IN BADAGRY LOCAL GOVERNMENT AREA, LAGOS STATE, NIGERIA

Abstract

Malaria remains a major public health problem among Pregnant Women (PW) in Sub Sahara Africa. Prevention of the disease will reduce the disease burden with improved quality of life. Insecticide Treated Net (ITN) has been successfully used in homes to prevent mosquito bite which leads to malaria. However, its uptake by pregnant women depend on their knowledge of malaria and perception of efficacy of ITN to prevent the illness. This study was therefore designed to investigate malaria related knowledge and ITN use among PW in Badagry Local Government Area (LGA), Lagos State, Nigeria. The study was a descriptive cross-sectional survey, which involved the use of a two-stage sampling technique to select 412 PW attending Primary Health Care Facilities (PHCF) in the LGA. All the 11 PHCF in the LGA which provide ANC services were purposively selected. Proportionate method was then used to determine the number of respondents selected from the facilities based on ratio of patient load. Systematic random sampling was used to select consenting respondents in each facility using registers of clinic attendees as sampling frames. Data were collected using a validated semi-structured interviewer-administered questionnaire. The content of the instrument included questions on respondents' socio- demographic characteristics. 23-point malaria and ITN knowledge scale, ITN use, ITN-related perception and malaria illness experiences. Knowledge scores ≤12 and >12 were categorized as poor and good respectively. Descriptive statistics and students' t-test were used for data analysis at α 0.05. Respondents' age was 29.3±5.0 years, 95.1% were married and 41.9% had tertiary education. Respondents. knowledge of malaria and ITN was 10.2±2.9 and 78.6% had poor knowledge. Only 33% could correctly list plasmodium as the causative agent of malaria. The correctly mentioned consequences of malaria in pregnancy included low birth weight (82.0%), abortion (50.1%), and anaemia (17.7%). Malaria was perceived by 85.4% to be a serious illness, while "agbo" (an herbal concoction) was perceived by 11.7% PW to be a better medication to prevent malaria compared to ITN. Some (10.4%) perceived ITN to have a chocking effect. Majority (81.8%) owned ITN at the time of the survey. However. regular ITN users constituted 56.6%, while 53.9% used it during the night preceding the study. Majority (76.0%) experienced malaria at least once during the current pregnancy. Knowledge score among respondents with no formal education was 12.2±3.2 and this was significantly higher than the score (10.8±3.1) obtained by those with formal education. Knowledge score of respondents who owned ITN (11.1±3.0) was significantly higher than the score (9.9±3.4) obtained by those who had none. Knowledge of malaria and uptake of insecticide treated nets among the pregnant women in Badagry were poor. The main factor which influenced the use of insecticide treated net among them was ownership of insecticide treated net. Public enlightenment, clinic based patient education, availability of nets to pregnant women and counseling services are recommended to tackle these challenges.