Levels of knowledge regarding malaria causes, symptoms, and prevention measures among Malawian women of reproductive age.

Abstract
Background: Malawi is a malaria-endemic country and approximately 6 million cases are reported annually. Improving knowledge of malaria causes and symptoms, and the overall perception towards malaria and its preventive measures is vital for malaria control. Thus, the current study investigated the levels of knowledge of the causes, symptoms, and prevention of Malaria among Malawian women. Methods: We analyzed data from the 2017 wave of the Malawi Malaria Indicator Survey (MIS). In total, 3,422 women of reproductive age (15–49 years) were sampled and analyzed. We assessed the levels of women’s knowledge about 1), causes of malaria 2) symptoms of malaria and 3) preventive measures. The tertiles of the composite score were used as the cut-offs to categorize the levels of knowledge as ‘‘low”, ‘‘medium” and ‘‘high”. Multinomial logistic regression models were constructed to assess the independent factors while taking into account the complex survey design. Results : All in all, 49.74% of all respondents had high levels of knowledge of causes, symptoms, and preventive measures. The high level of knowledge was 45% for rural women and 55% for urban dwellers. After adjustment for independent factors, women of age group 15–19 years adjusted odds ratio ([aOR]: 2.58; 95% Confidence Interval [CI]: 1.69–3.92), women with no formal education (aOR: 3.73; 95% CI: 2.20–6.33), women whose household had no television (aOR: 1.50; 95% CI: 1.02–2.22), women who had not seen/heard malaria message (aOR: 1.53; 95% CI: 1.20–1.95), women of Yao tribe (aOR: 1.95; 95% CI: 1.10–3.46) and women from rural areas had low levels of knowledge about the causes of malaria, symptoms of malaria, and preventive measures. Additionally, the results also showed that women aged 15–19 years (beta [β] = -0.73, standard error [SE] = 0.12); P <.0001, women with no formal education (β = -1.17, SE = 0.15); P <.0001, women whose household had no radio (β = -0.15, SE = 0.0816); P =0.0715 and women who had not seen or heard malaria message (β = -0.41, SE = 0.07); P <.0001 were likely to have a lower knowledge score. Conclusions: The levels of malaria knowledge were reported to be unsatisfactory among adult women, underscoring the need to scale up efforts on malaria education. Beside insecticide-treated bed nets (ITNs) and prompt diagnosis, malaria can be best managed in Malawi by increasing knowledge of malaria causes, and symptoms especially for younger women, women with no formal education, women whose households have no media, women from Yao tribes and rural dwellers.