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  • Title: A malaria control trial using insecticide-treated bed nets and targeted chemoprophylaxis in a rural area of The Gambia, west Africa. 4. Perceptions of the causes of malaria and of its treatment and prevention in the study area.
    Author: Aikins MK, Pickering H, Alonso PL, D'Alessandro U, Lindsay SW, Todd J, Greenwood BM.
    Journal: Trans R Soc Trop Med Hyg; 1993 Jun; 87 Suppl 2():25-30. PubMed ID: 8212106.
    Abstract:
    Perceptions of the causes of malaria, its treatment and prevention were studied among 996 adults, selected randomly from 73 villages and hamlets in a rural area of The Gambia. Structured questionnaires and other interview techniques were used for data collection. Malaria has no specific name in the study area; it is referred to commonly as Fula kajewo (Fula fever). Only 28% of the respondents knew that mosquitoes transmitted malaria. However, most people believed correctly that August to October was the main malaria season. Eighty-six per cent of the subjects were bed net users. The majority of nets were produced locally, usually white in colour and made of sheeting fabrics. Usage of nets was correlated with ethnic group, age and polygamy but not with education, income, occupation or ownership of certain items which indicate high social status. Analysis of expenditure on mosquito coils indicated that non-users of nets spent 43% more on coils than did users. Bed nets have been used for a long time in the study area; 98% of users saw their parents using them during their childhood. In the Gambia, malaria specialists at the Medical Research Council Laboratories oversaw interviews of 996 men and women from, 73 villages and hamlets on the south bank of the River Gambia to learn their perceptions of the causes of malaria and of its treatment and prevention. No specific local term for malaria existed. The most common term used by all ethnic groups, except the Fulas, was Fula kejewo (Fula fever). Just 28% of all adults knew that mosquitoes transmit malaria. Men were more likely to know the real cause of malaria than women (p .001). Knowledge about the cause of malaria increased with education p =.01). Most people (90%) knew that malaria transmission occurs most often during August-October. 86% of adults and 81% of their children less than 10 years old used bed nets. Girls were more likely to sleep under bed nets than boys (p = .005). Local tailors made most bed nets with either second hand or new fabrics. They tended to be made of sheeting fabrics and white in color. Most adults were willing to treat their bed nets with the insecticide permethrin to protect against mosquitoes. Ethnic group (Fulas less likely, p .001), age (older people more likely, p .001), and polygamy (p = .002) were correlated with bed net use. Education, income, and occupation or ownership of items indicating high social status were not correlated with bed net use. Nonusers of bed nets spent 43% more on mosquito coils, used to smoke out mosquitoes from rooms before going to sleep, than did users (p = .001). Almost all adults (98%) remembers their parents using bed nets when they were children. The bed nets users who were at least 70 years old said that the Mandinkas mainly used bed nets. These findings should prove useful to the government as it develops a national impregnated bed net program to control malaria in rural areas.
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