Knowledge of malaria and adherence to its preventive measures among adults attending out-patient clinics of a Nigerian tertiary hospital: Has anything changed?

Background: Despite global control efforts, malaria still accounts for preventable morbidity and mortality in Africa. Reported knowledge of its preventive measures appears high, but disparity exists between knowledge and uptake of preventive practices in Nigeria. It becomes necessary to evaluate adherence to use of insecticide-treated nets (ITN) and other malaria preventive measures at peak periods of malaria transmission as the Millennium Development Goal era terminates. Materials and Methods: A cross-sectional study was conducted at the general and pediatric out-patient clinics of Aminu Kano Teaching Hospital, among 413 adult patients and caregivers of children selected by systematic sampling technique and using a validated interviewer-administered questionnaire. Their knowledge of malaria and utilization of and adherence to preventive measure utilization were assessed. Results: The respondents’ mean age was 33.6 ± 8.9 years. Majority (90.6%) had adequate knowledge of malaria. Their mean malaria knowledge score was 78.7%. Among those who used ITNs, only 54.1% adhered to daily use. For other preventive measures, 65.3, 52.3, 46.5, and 25.2% adhered to environmental sanitation, insecticide spraying, wearing protective clothing, and mosquito repellent use, respectively. Hot weather was the main barrier to ITNs and wearing protective clothing adherence, whereas cost, lack of time, fear of side effects was the barrier to adherence to insecticide spraying, environmental sanitation, and mosquito repellent, respectively. Tertiary education was associated with adequate knowledge of malaria (χ2 = 8.36, P = 0.004). There was also association between adequate knowledge of malaria and monthly environmental sanitation participation (χ2 = 9.06, P = 0.003). Conclusion: Knowledge of malaria was high but adherence to practice was low. Nonadherence with preventive measures is an obstacle to achieving malaria control and could be overcome by effective mass education and addressing adherence barriers.