Project – Assessment of Mosquito-Borne Disease Risk and Community-Based Prevention Practices among Residents of Selected Communities in Port Harcourt Metropolis, Rivers State, Nigeria

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Mosquito-borne diseases remain among the most important public health challenges in tropical and subtropical regions of the world. Mosquitoes are vectors capable of transmitting parasites, viruses and other pathogens to humans, making them important contributors to infectious disease morbidity and mortality. Major mosquito-borne diseases include malaria, dengue, yellow fever, chikungunya, lymphatic filariasis and Zika virus disease. Collectively, vector-borne diseases account for more than 17% of infectious diseases and cause more than 700,000 deaths annually, with the greatest burden occurring in tropical and subtropical populations (World Health Organization [WHO], 2024).

Among mosquito-borne diseases, malaria remains particularly important in sub-Saharan Africa. Malaria is caused by Plasmodium parasites and transmitted principally through the bites of infected female Anopheles mosquitoes. Although malaria is preventable and curable, delayed diagnosis and treatment can result in severe illness and death (WHO, 2025). The continuing burden of malaria illustrates the importance of understanding not only the biological transmission of mosquito-borne diseases but also the environmental, behavioural and social conditions that determine people’s exposure to mosquito vectors.

Globally, malaria continues to constitute a substantial public health problem. The World Health Organization estimated that approximately 263 million malaria cases and 597,000 malaria deaths occurred globally in 2023, with approximately 95% of malaria deaths occurring in the WHO African Region (WHO, 2024). More recent WHO estimates indicate that the global malaria burden increased to approximately 282 million cases and 610,000 deaths in 2024. Nigeria remains one of the countries carrying a very substantial share of the global malaria burden; WHO reported that Nigeria accounted for about 31.9% of malaria deaths in the African Region in 2024 (WHO, 2025).

Nigeria’s position within the global malaria burden makes mosquito-borne disease prevention an important national and community health priority. The 2024 WHO malaria report indicated that Nigeria accounted for approximately 55% of estimated malaria cases in the West African subregion in 2023. The country also continued large-scale distribution of insecticide-treated mosquito nets as part of its malaria control programme (WHO, 2024). The Nigeria Malaria Indicator Survey (NMIS) provides nationally representative information on malaria prevention, diagnosis and treatment and remains an important source for understanding household-level malaria control practices in the country (National Malaria Elimination Programme [NMEP] & National Population Commission [NPC], 2022).

The risk of mosquito-borne disease, however, is not determined by the presence of mosquitoes alone. It results from an interaction among mosquito ecology, environmental conditions, human behaviour, housing characteristics, socioeconomic circumstances, climatic conditions and access to preventive and health services. Poor environmental sanitation, stagnant water, indiscriminate disposal of solid waste, blocked drainage channels and uncovered water containers can provide breeding habitats for mosquitoes. Similarly, poorly screened windows and doors, outdoor activities during mosquito biting periods, inconsistent use of insecticide-treated nets and inadequate personal protection may increase human exposure.

Urbanisation creates an additional dimension to mosquito-borne disease risk. Although mosquitoes are often associated with rural environments, urban and peri-urban communities can provide numerous artificial breeding habitats. Construction sites, discarded containers, blocked drains, discarded tyres, household water-storage containers and poorly managed waste can retain water and provide suitable habitats for mosquito larvae. The WHO Global Vector Control Response 2017–2030 therefore emphasizes that effective vector control requires locally adapted approaches that combine surveillance, environmental management, community participation and appropriate vector-control technologies (WHO, 2017).

The ecological conditions of Port Harcourt Metropolis make the assessment of mosquito-borne disease risk particularly relevant. Port Harcourt is a major urban centre in Rivers State and is characterised by extensive residential development, commercial activities, transportation networks, drainage systems, construction activities and areas where water can accumulate. The humid tropical environment of the Niger Delta can also provide favourable conditions for mosquito survival and reproduction. Research on mosquito ecology in Port Harcourt and its environs has documented the presence of different mosquito groups, including Anopheles, Culex and Aedes, across different microhabitats (Ogbalu & Onwuteaka, 2016).

The occurrence of different mosquito genera has important public health implications because different mosquitoes transmit different pathogens and exhibit different breeding and biting behaviours. Anopheles mosquitoes are particularly associated with malaria transmission, while Aedes mosquitoes can transmit diseases such as dengue, yellow fever and chikungunya. Culex mosquitoes are also important vectors of several pathogens. Consequently, mosquito-borne disease risk in an urban setting should not be conceptualised solely as the risk of malaria but should encompass the broader environmental and behavioural conditions that facilitate mosquito proliferation and human-vector contact.

Port Harcourt and the wider Rivers State area have also been the subject of research concerning malaria prevention and mosquito control. For example, Ordinioha (2006) investigated perceptions of insecticide-treated nets among users in a semi-urban community in Rivers State and found that sustained health education and ITN use could promote malaria control. In another study conducted in a semi-urban community in Rivers State, Ordinioha (2007) observed that although households had purchased insecticide-treated nets, actual deployment of the nets was relatively low. Factors such as high night-time temperature, perceived absence of mosquitoes and forgetting to put up the net were reported as reasons for non-use.

Similarly, Ordinioha (2012) examined the use and misuse of free insecticide-treated nets in Ishiodu, Emohua, Rivers State. Although all households in the study owned at least one ITN, only a relatively small proportion of the properly deployed nets were actually used the previous night. The study demonstrated an important distinction between ownership of preventive materials and actual preventive behaviour. This distinction is particularly relevant to the present study because the existence of mosquito nets, insecticides or other preventive resources within a community does not necessarily mean that residents consistently use them or that environmental risk is adequately controlled.

Community-based prevention is therefore an important component of mosquito-borne disease control. The WHO Global Vector Control Response identifies community engagement and mobilisation as one of the four major pillars of effective vector control, alongside intersectoral collaboration, enhanced surveillance, and the scaling-up and integration of appropriate vector-control tools (WHO, 2017). Community participation is important because many mosquito breeding sites are located around homes and neighbourhoods and therefore cannot be effectively controlled by health authorities alone.

Community-based prevention practices may include regular clearing of bushes and vegetation around residences, proper disposal of refuse, removal of stagnant water, cleaning of drainage channels, covering water-storage containers, use of insecticide-treated nets, installation of window and door screens, use of mosquito repellents, indoor insecticide application and prompt seeking of appropriate healthcare when symptoms suggestive of malaria occur. The effectiveness of these measures depends substantially on residents’ knowledge, perceptions, socioeconomic circumstances and willingness to adopt and sustain preventive behaviours.

Evidence from Nigeria demonstrates that knowledge of malaria does not always translate into appropriate preventive practice. Onwujekwe et al. (2000), in a study of five Nigerian communities, reported considerable awareness of malaria and mosquito nets, but ownership of mosquito nets was relatively low in several of the communities. The researchers concluded that the willingness of households to obtain ITNs presented opportunities for sustainable community-based malaria prevention programmes.

Similarly, Adebukola et al. (2022) found substantial variation in malaria prevention practices among children living in a rural Nigerian community. Only 30.8% of participants owned mosquito nets, while other practices included the use of insecticides, local herbs, window nets, door nets and mosquito repellent creams. The study highlighted socioeconomic differences in access to and use of malaria prevention methods. These findings reinforce the need to examine preventive practices within specific communities rather than assuming that national malaria-control interventions are uniformly implemented at household level.

Community education can substantially improve preventive behaviour. In a study involving two rural communities in Rivers State, community volunteers were trained to improve knowledge and management of childhood malaria. Following the intervention, adequate knowledge of malaria prevention increased considerably, while ITN use increased from 46.7% to 87.5% in the intervention group (Ordinioha et al., 2015). This finding suggests that community-based approaches can strengthen the capacity of residents to participate actively in malaria prevention.

Evidence also suggests that integrated approaches combining personal protection and environmental management can be valuable. A Nigerian intervention study found that integrated vector-management activities involving household training, provision of long-lasting insecticidal nets, improved waste management and screening of doors and windows were associated with reductions in malaria infection (Akinyemi et al., 2023). Such findings support the principle that mosquito-borne disease prevention should extend beyond reliance on a single intervention.

The distinction between mosquito-borne disease risk and community prevention practices is therefore central to the present study. Risk assessment involves examining the conditions that increase the probability of mosquito-human contact and disease transmission. These conditions may include the presence of mosquito breeding sites, stagnant water, poor drainage, inadequate waste management, housing conditions, perceived mosquito abundance and individual exposure patterns. Prevention practices, on the other hand, involve the actions taken by residents and communities to reduce mosquito breeding, prevent mosquito bites and respond appropriately to suspected disease.

An assessment of these two dimensions is particularly valuable in an urban metropolis such as Port Harcourt because different communities may experience different levels of environmental exposure and may adopt different preventive practices. Some neighbourhoods may have effective drainage and waste management systems, while others may experience stagnant water, indiscriminate refuse disposal or inadequate environmental sanitation. Likewise, residents may differ in their ownership and use of insecticide-treated nets, use of repellents, screening of houses, environmental cleaning and health-seeking behaviour.

The need for locally generated evidence is consistent with the WHO approach to vector control, which recommends vector surveillance and needs assessment as a basis for developing locally appropriate interventions (WHO, 2017). A community-level assessment can reveal the specific environmental and behavioural factors that contribute to mosquito-borne disease risk and identify gaps between knowledge and actual preventive practices.

It is against this background that this study seeks to assess mosquito-borne disease risk and community-based prevention practices among residents of selected communities in Port Harcourt Metropolis, Rivers State, Nigeria. By examining residents’ knowledge and perception of mosquito-borne disease risk, environmental risk factors and household/community prevention practices, the study is expected to generate evidence that can support more effective community health education, environmental sanitation, vector surveillance and locally appropriate mosquito-control interventions.

1.2 Statement of the Problem

Mosquito-borne diseases remain a major public health concern in Nigeria despite decades of malaria-control programmes and the availability of effective preventive measures. Nigeria continues to account for a disproportionately large share of malaria cases and deaths in Africa. The persistence of this burden suggests that the availability of interventions alone is insufficient and that environmental, behavioural, socioeconomic and health-system factors continue to influence transmission (WHO, 2024, 2025).

One important problem is the continued existence of mosquito breeding conditions within residential communities. In rapidly growing urban environments, inadequate drainage, accumulated refuse, discarded containers, construction activities and stagnant water can create suitable habitats for mosquitoes. Port Harcourt Metropolis, with its humid tropical environment and extensive urban development, presents conditions that may facilitate mosquito breeding. Research conducted in Port Harcourt has identified Anopheles, Aedes and Culex mosquitoes in different microhabitats, demonstrating the ecological presence of mosquito vectors in the metropolis (Ogbalu & Onwuteaka, 2016).

A second problem concerns the gap between availability of preventive interventions and their actual use. Insecticide-treated mosquito nets remain one of the principal tools for malaria prevention, yet Nigerian studies have repeatedly demonstrated that ownership does not necessarily translate into consistent use. Ordinioha (2012), for example, found that although ITN ownership was universal among the households studied in a semi-urban Rivers State community, actual utilisation was considerably lower. Similarly, previous research in south-south Nigeria demonstrated that factors such as heat, perceived mosquito abundance and household circumstances influenced whether residents used their nets appropriately (Ordinioha, 2007).

A third problem is that residents may possess knowledge about mosquitoes and malaria without consistently translating that knowledge into effective preventive behaviour. Nigerian studies have demonstrated discrepancies between knowledge, ownership and actual utilisation of preventive measures (Onwujekwe et al., 2000; Ordinioha, 2012). Consequently, measuring only knowledge or only availability of mosquito-control materials may provide an incomplete picture of community protection.

Another concern is that mosquito-borne disease prevention is frequently approached predominantly from an individual or household perspective, whereas mosquito breeding and transmission are also community-level problems. A household may cover its water containers and sleep under an ITN but remain exposed to mosquitoes breeding in blocked drains, abandoned containers, poorly managed refuse areas or neighbouring premises. Effective control therefore requires collective action involving households, community leaders, environmental health personnel, local authorities and health institutions. The WHO Global Vector Control Response specifically emphasises community engagement, vector surveillance and intersectoral collaboration as essential components of sustainable vector control (WHO, 2017).

There is also a concern that environmental sanitation practices may vary substantially between communities within the same metropolitan area. While some communities may maintain clean surroundings and functional drainage systems, others may experience persistent environmental conditions favourable to mosquito breeding. Without community-specific assessment, it may be difficult to determine which environmental and behavioural factors are most important in particular neighbourhoods.

Furthermore, the focus on malaria may obscure the broader issue of mosquito-borne disease risk. Different mosquito genera transmit different diseases, and urban mosquito ecology includes Aedes and Culex species in addition to malaria-transmitting Anopheles. WHO has emphasised that urban and peri-urban environments can support mosquito vectors and create conditions for transmission of several vector-borne diseases (WHO, 2017, 2024). Therefore, an assessment limited exclusively to malaria may fail to capture the wider mosquito-related health risks faced by urban residents.

The problem is further complicated by variations in socioeconomic status, housing quality, educational level, occupation, access to health information and access to preventive resources. These factors can influence residents’ ability and willingness to adopt mosquito-control practices. Evidence from Nigerian communities has shown that socioeconomic and educational factors can influence malaria-related knowledge and prevention practices (Adebukola et al., 2022; Fatunla et al., 2022).

Although previous studies have examined malaria prevention, ITN use and mosquito ecology in Rivers State and other parts of Nigeria, there remains a need for an integrated assessment that simultaneously considers mosquito-borne disease risk and community-based prevention practices among residents of selected communities within Port Harcourt Metropolis. Such an assessment is important because the actual risk experienced by residents is shaped by the interaction between environmental exposure and preventive behaviour.

The central problem, therefore, is that mosquito-borne disease transmission may continue in Port Harcourt communities despite the availability of established preventive measures because environmental risk factors and community prevention practices may not be adequately understood or consistently implemented. Without current community-level evidence on the perceived and observable risk factors and the prevention practices adopted by residents, health authorities and community stakeholders may have difficulty designing interventions that address the specific realities of affected neighbourhoods.

This study consequently seeks to assess mosquito-borne disease risk and community-based prevention practices among residents of selected communities in Port Harcourt Metropolis, Rivers State, Nigeria. The findings are expected to provide evidence on the major risk factors, preventive behaviours and gaps that may require targeted public health intervention.

1.3 Purpose of the Study

The main purpose of this study is to assess mosquito-borne disease risk and community-based prevention practices among residents of selected communities in Port Harcourt Metropolis, Rivers State, Nigeria.

Specifically, the study seeks to:

1. assess the level of knowledge of mosquito-borne diseases among residents of selected communities in Port Harcourt Metropolis;
2. identify the major environmental and household factors that contribute to mosquito-borne disease risk in the selected communities;
3. assess residents’ perceptions of their risk of contracting mosquito-borne diseases;
4. determine the community-based and household mosquito prevention practices adopted by residents

1.4 Research Questions

The following research questions will guide the study:

1. What is the level of knowledge of mosquito-borne diseases among residents of selected communities in Port Harcourt Metropolis?
2. What environmental and household factors contribute to mosquito-borne disease risk in the selected communities?
3. How do residents perceive their risk of contracting mosquito-borne diseases?
4. What mosquito-borne disease prevention practices are adopted by residents of the selected communities?

1.5 Research Hypothesis

The following null hypothesis will be tested at 0.05 level of significance:

H₀: There is no significant relationship between residents’ knowledge of mosquito-borne diseases and their adoption of community-based mosquito prevention practices in selected communities in Port Harcourt Metropolis, Rivers State.

1.6 Significance of the Study

The study will be significant to several groups.

Public Health Authorities

The findings will provide public health authorities with evidence concerning environmental and behavioural factors associated with mosquito-borne disease risk in selected Port Harcourt communities. Such information can assist in developing targeted health education, vector-control and environmental sanitation programmes.

Rivers State Ministry of Health

The study may provide useful evidence for strengthening community-based malaria and vector-control interventions in Rivers State. Findings on prevention practices and barriers to utilisation can help policymakers design interventions that are more responsive to the circumstances of urban residents.

Local Government Authorities

Local government authorities responsible for environmental health and sanitation may benefit from information about environmental conditions associated with mosquito breeding. The findings may support improved drainage maintenance, refuse management, environmental sanitation campaigns and community mobilisation.

Community Leaders and Residents

The study will help community leaders and residents understand the relationship between household environmental conditions, mosquito exposure and disease risk. It may also encourage collective action to eliminate breeding sites and improve the consistent use of appropriate mosquito-control measures.

Health Educators and Community Health Workers

The findings may assist community health workers in identifying misconceptions and behavioural gaps that require health education. Evidence from previous Nigerian studies indicates that community education and mobilisation can improve knowledge and preventive behaviour (Ordinioha et al., 2015).

Researchers and Students

The study will contribute to the body of literature on mosquito-borne diseases, environmental health and community-based disease prevention in Nigeria. It may also serve as a reference for future studies examining mosquito ecology, malaria prevention, community participation and urban public health.

Policy and Programme Development

The study will contribute evidence that can support the WHO principle of locally adapted vector control, which emphasises surveillance, community engagement, intersectoral collaboration and integrated interventions (WHO, 2017).

1.7 Scope of the Study

The study focuses on the assessment of mosquito-borne disease risk and community-based prevention practices among residents of selected communities in Port Harcourt Metropolis, Rivers State, Nigeria.

The content scope will cover residents’ knowledge of mosquito-borne diseases, perceived risk, environmental and household risk factors, mosquito breeding conditions, housing characteristics, mosquito exposure, use of insecticide-treated nets, use of mosquito repellents and insecticides, window and door screening, environmental sanitation, elimination of stagnant water, refuse disposal, water-storage practices and other community-level prevention measures.

The study will also examine barriers to effective mosquito-borne disease prevention and the relationship between knowledge and preventive practices.

Geographically, the study will be limited to selected communities within Port Harcourt Metropolis, Rivers State. The selection of communities will be based on the sampling procedure described in Chapter Three.

The study will focus primarily on residents and will not constitute a clinical trial or laboratory investigation of mosquito-borne pathogens. Unless specifically incorporated into the methodology, the study will not attempt to identify mosquito species through entomological laboratory testing or establish laboratory-confirmed infection among respondents.

1.8 Operational Definition of Terms

Assessment: A systematic process of collecting and analysing information to determine the level of mosquito-borne disease risk and the prevention practices adopted by residents.

Community-based prevention: Collective or household actions undertaken by residents, community groups and other local stakeholders to prevent mosquito breeding, reduce mosquito-human contact and minimise mosquito-borne disease transmission.

Community: A defined geographical area in which people live and share environmental and social characteristics.

Insecticide-treated net (ITN): A mosquito net treated with insecticide to provide physical and chemical protection against mosquito bites, particularly during sleeping hours.

Malaria: A mosquito-borne parasitic disease caused by Plasmodium parasites and transmitted mainly through the bites of infected female Anopheles mosquitoes.

Mosquito-borne diseases: Diseases transmitted to humans through mosquitoes, including malaria and other diseases associated with mosquito vectors such as dengue, yellow fever, chikungunya and lymphatic filariasis.

Mosquito breeding site: Any natural or artificial location containing water or environmental conditions suitable for mosquito reproduction and development.

Mosquito prevention practices: Actions undertaken by individuals or communities to prevent mosquito breeding, avoid mosquito bites and reduce the risk of mosquito-borne disease transmission.

Mosquito-borne disease risk: The likelihood that individuals or communities may be exposed to mosquito vectors and subsequently contract a disease transmitted by mosquitoes, based on environmental, behavioural and household factors.

Port Harcourt Metropolis: The urban area of Port Harcourt in Rivers State within which the selected study communities are located.

Residents: Individuals who live within the selected communities and meet the eligibility criteria established for participation in the study.

Vector: An organism capable of transmitting an infectious pathogen from an infected host to another human or animal. In this study, the principal vectors of interest are mosquitoes.

Project – Assessment of Mosquito-Borne Disease Risk and Community-Based Prevention Practices among Residents of Selected Communities in Port Harcourt Metropolis, Rivers State, Nigeria