Project – Assessment of Community Knowledge, Attitudes and Practices Regarding Mosquito-Borne Disease Prevention among Households in Selected Communities in Bassa, Ankpa, Dekina, Ofu and Ibaji

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Mosquito-borne diseases remain among the most important infectious disease problems affecting populations in tropical and subtropical regions of the world. Mosquitoes serve as vectors for a range of parasites and viruses capable of causing diseases such as malaria, dengue, yellow fever, chikungunya, lymphatic filariasis and other arboviral infections. The public health importance of mosquitoes arises from their ability to transmit pathogens between infected and susceptible hosts, thereby sustaining disease transmission within communities. The World Health Organization (WHO) identifies vector-borne diseases as a major global health concern and emphasises integrated vector control, surveillance and community participation as essential components of disease prevention (World Health Organization [WHO], 2017).

Among mosquito-borne diseases, malaria remains particularly important in sub-Saharan Africa. Malaria is caused by Plasmodium parasites and transmitted mainly through the bites of infected female Anopheles mosquitoes. It is preventable and curable, but untreated or inadequately treated malaria can progress to severe disease and death. According to the WHO, malaria continues to be concentrated heavily in the African Region, with Nigeria consistently among the countries carrying the greatest malaria burden globally (WHO, 2025).

Nigeria’s malaria situation makes household and community prevention particularly important. The 2021 Nigeria Malaria Indicator Survey reported that 56% of households owned at least one insecticide-treated net (ITN), while only 36% of the de facto population slept under an ITN the night before the survey. Among children under five years, 41% slept under an ITN, while 50% of pregnant women slept under one (National Malaria Elimination Programme [NMEP] & National Population Commission [NPC], 2022). These figures illustrate an important public health gap: possession or availability of preventive commodities does not necessarily translate into consistent utilisation.

The persistence of malaria and other mosquito-borne diseases is influenced by a combination of environmental, biological, socioeconomic and behavioural factors. While mosquito control programmes provide important preventive tools, the effectiveness of these interventions depends considerably on whether households understand the risks associated with mosquito bites and whether they consistently practise recommended preventive behaviours. Consequently, knowledge, attitudes and practices (KAP) have become important areas of investigation in community health research.

Knowledge refers to what individuals understand about a disease, its causes, modes of transmission, symptoms, prevention and treatment. In relation to mosquito-borne diseases, knowledge may include awareness that mosquitoes transmit malaria, understanding mosquito biting times, recognition of mosquito breeding sites, knowledge of symptoms and awareness of preventive measures such as insecticide-treated nets, indoor residual spraying, environmental sanitation and repellents. Adequate knowledge is important because people are more likely to adopt preventive behaviours when they understand the health risks associated with exposure.

However, knowledge alone does not automatically result in appropriate behaviour. Attitudes represent people’s beliefs, perceptions, feelings and dispositions towards a disease and its prevention. A household may know that mosquitoes transmit malaria but may not consider mosquito-borne diseases sufficiently serious to justify consistent preventive action. Conversely, individuals who perceive malaria as a serious and recurrent disease may be more motivated to use ITNs, maintain clean surroundings and seek appropriate care when symptoms occur.

Practices, on the other hand, refer to the actual actions undertaken by individuals or households. In mosquito-borne disease prevention, practices may include sleeping under insecticide-treated nets, clearing bushes around houses, removing stagnant water, covering water-storage containers, disposing of refuse appropriately, cleaning drainage channels, using mosquito repellents and seeking prompt diagnosis and treatment when illness occurs.

The importance of assessing these three dimensions is supported by evidence from Nigerian communities. Onwujekwe et al. (2000), in a study of five Nigerian communities, found that many respondents had considerable knowledge about malaria and mosquito nets and perceived malaria as an important health problem. Nevertheless, ownership of mosquito nets was low in several of the communities. The study demonstrated that awareness and perceived importance of malaria do not necessarily guarantee adoption of preventive commodities.

Similarly, Dike et al. (2006) investigated the influence of education and knowledge on malaria perceptions and practices in Southeast Nigeria. The researchers found that educational attainment and knowledge influenced perceptions and malaria-related practices, demonstrating the importance of socioeconomic and educational factors in determining how communities respond to malaria risk.

Evidence from other Nigerian settings further demonstrates the gap that may exist between knowledge and actual preventive behaviour. A community-based study in rural Aliero, northern Nigeria, found that comprehensive knowledge about malaria prevention was high among respondents, but this did not translate into similarly high levels of preventive practice. The researchers concluded that misconceptions and gaps between knowledge and practice remained important obstacles to malaria control (Adedotun et al., 2010).

The same pattern has been observed in other parts of Nigeria. In an urban community in Oyo State, Adebayo et al. (2010) found that most respondents recognised mosquito bites as a cause of malaria, yet ITN use among children was low. In addition, many households relied on insecticides and other methods for malaria prevention. The study concluded that malaria control requires active community involvement and that health education should be intensified.

More recent evidence from Lagos State also highlights the importance of KAP assessment. A 2021 study involving 520 respondents examined knowledge, attitudes and practices regarding malaria vector-control strategies. The researchers reported substantial use of ITNs and indoor residual spraying but also found that educational level and housing type influenced some attitudes and practices. The authors recommended that malaria control programmes should take local KAP characteristics into consideration when implementing vector-control strategies (Akinleye et al., 2021).

The relationship between knowledge and practice is therefore not straightforward. Individuals may possess correct knowledge but encounter practical, economic or environmental barriers that prevent them from applying that knowledge. For example, a household may know that ITNs prevent mosquito bites but fail to use them because of heat, discomfort, damaged nets, inadequate numbers of nets or perceptions that mosquitoes are not abundant. Similarly, residents may understand the importance of environmental sanitation but lack adequate waste disposal facilities or effective drainage systems.

Household socioeconomic characteristics may also influence prevention. Income can determine the ability of households to purchase repellents, repair housing structures, install window screens or replace damaged mosquito nets. Education can influence access to health information and interpretation of public health messages. Housing characteristics, including the presence of window and door screens, roof construction and ventilation, may influence mosquito-human contact. These factors demonstrate why KAP studies are important for identifying not only what communities know but also why recommended practices may or may not be adopted.

The importance of household practices is further demonstrated by the Nigeria Malaria Indicator Survey. Although more than half of Nigerian households owned at least one ITN in 2021, access and actual utilisation were considerably lower than universal coverage. This difference between ownership, access and utilisation illustrates the need to investigate the behavioural dimensions of malaria prevention rather than relying solely on distribution statistics (NMEP & NPC, 2022).

The issue is particularly relevant to rural and semi-rural communities. Rural households may experience environmental conditions that facilitate mosquito breeding, including stagnant water, agricultural water bodies, poor drainage, bushes and inadequate waste disposal. At the same time, access to health information and preventive commodities may be more limited than in some urban settings. A study of rural Nigerian communities found that misconceptions about malaria continued to influence perceptions and practices and that educational interventions were needed to strengthen prevention (Adedotun et al., 2010).

Community participation is consequently central to sustainable mosquito-borne disease control. WHO’s Global Vector Control Response identifies community engagement and mobilisation as one of the key pillars of effective vector control. Communities need to participate in identifying breeding sites, maintaining environmental sanitation, adopting household protection measures and supporting local vector-control activities (WHO, 2017).

The concept of community participation is particularly important because mosquito breeding and human exposure frequently occur around the household environment. Residents can directly influence the number of potential breeding sites by how they store water, dispose of waste, manage vegetation and maintain drainage around their homes. They can also reduce exposure by sleeping under ITNs, using appropriate repellents and improving household screening.

However, community participation cannot be assumed. People’s beliefs about the causes of malaria and other mosquito-borne diseases may influence whether they accept scientifically recommended interventions. Historical research in Nigerian communities has shown that cultural and ethnomedical beliefs can influence perceptions of malaria, treatment decisions and prevention practices (Ezedinachi et al., 1996).

Health-seeking behaviour is another important component of community practice. Prevention does not end with avoiding mosquito bites. When individuals develop symptoms consistent with malaria, prompt testing and appropriate treatment are essential. WHO recommends early diagnosis and effective treatment because uncomplicated malaria can progress to severe disease if appropriate care is delayed (WHO, 2025).

Community education has been shown to improve malaria-related knowledge and behaviour. For example, a community-based intervention in rural Nigeria involving information activities, posters, drama groups and jingles significantly improved caregivers’ recognition of malaria and appropriate home-management and referral practices (Okafor et al., 2009). This demonstrates that health education and community mobilisation can influence behaviour when interventions are adapted to local needs.

Another study involving mothers in rural communities in Nigeria found that considerable misconceptions about childhood malaria persisted despite widespread use of preventive measures. The study reported that education was associated with perceptions of malaria and concluded that addressing misconceptions was important for malaria control (Oladimeji et al., 2015).

The selected communities for this study—Bassa, Ankpa, Dekina, Ofu and Ibaji—are located in Kogi State and provide an important setting for examining household knowledge, attitudes and practices concerning mosquito-borne disease prevention. The communities have different geographical, environmental, socioeconomic and settlement characteristics. Such variations may influence exposure to mosquitoes, access to health information, household prevention practices and perceptions of mosquito-borne disease.

Bassa, Ankpa, Dekina, Ofu and Ibaji include communities where rural livelihoods, agricultural activities, water bodies and environmental conditions may influence mosquito breeding and exposure. The presence of streams, ponds, drainage channels, agricultural areas and water-storage practices can potentially create breeding opportunities, while household characteristics and socioeconomic circumstances may influence the adoption of preventive measures.

The selection of multiple communities is important because KAP cannot necessarily be generalised from one community to another. Even where communities are located within the same state, differences in education, occupation, income, housing, cultural beliefs, access to health services and environmental conditions can produce different prevention behaviours. Comparative assessment can therefore identify whether KAP patterns are relatively consistent or vary significantly across the selected locations.

The study is also justified by the fact that KAP represents an important link between public health programmes and household behaviour. Government and development partners may distribute ITNs, provide health education and support vector-control activities, but the ultimate public health impact depends partly on whether households understand the interventions, accept them and use them correctly.

The present study therefore approaches mosquito-borne disease prevention from a household and community perspective. Rather than concentrating exclusively on malaria prevalence, the study will assess what residents know about mosquito-borne diseases, how seriously they perceive the diseases, what beliefs they hold concerning prevention and what preventive measures they actually practise.

Such an approach is particularly important because knowledge gaps may identify the need for health education, negative attitudes may indicate the need for behavioural-change communication, while inappropriate practices may point to practical barriers requiring intervention. Understanding these dimensions together can provide more useful information for designing effective community health programmes.

Furthermore, assessing KAP can help identify discrepancies between public health recommendations and household realities. For example, if households know that mosquito nets are effective but do not use them regularly, the problem may be related to discomfort, inadequate supply, poor maintenance or misconceptions. If households understand that stagnant water supports mosquito breeding but do not eliminate it, environmental infrastructure or community-level sanitation problems may be responsible.

Therefore, the study is designed to generate empirical evidence on the knowledge, attitudes and practices of households regarding mosquito-borne disease prevention in selected communities in Bassa, Ankpa, Dekina, Ofu and Ibaji. The evidence generated may assist public health authorities, community health workers, local government authorities and community leaders in developing interventions that address the actual behavioural and environmental circumstances of households.

1.2 Statement of the Problem

Mosquito-borne diseases, particularly malaria, remain a major public health problem in Nigeria despite the availability of effective preventive interventions. Nigeria continues to experience one of the world’s largest malaria burdens, and WHO reports that malaria remains endemic in the country and constitutes a substantial proportion of the African malaria burden (WHO, 2025).

The continued burden of mosquito-borne diseases raises an important public health question: to what extent do households possess the knowledge, attitudes and practices necessary to prevent mosquito-borne disease effectively? The availability of preventive measures does not automatically guarantee their use. The 2021 Nigeria Malaria Indicator Survey showed that 56% of households owned at least one ITN, yet only 36% of the de facto population slept under an ITN the night before the survey (NMEP & NPC, 2022). This gap suggests that distribution and ownership must be complemented by behavioural and community-level interventions.

A major problem is therefore the possibility of a knowledge-practice gap among households. Some residents may know that mosquitoes transmit malaria and understand the importance of mosquito nets but may not consistently use them. Evidence from rural Nigeria has demonstrated that high knowledge of malaria prevention does not necessarily translate into appropriate preventive practice (Adedotun et al., 2010).

Another concern is the persistence of misconceptions about mosquito-borne diseases. In some communities, malaria may be attributed to causes other than mosquito transmission, while symptoms may be interpreted through traditional, cultural or other explanatory frameworks. Such beliefs can affect prevention and treatment decisions. Earlier Nigerian research showed that sociocultural and ethnomedical beliefs influenced community perceptions and practices concerning malaria (Ezedinachi et al., 1996).

The problem also involves attitudes towards preventive measures. A household may be aware of ITNs but perceive them as uncomfortable, unnecessary or inconvenient. Some residents may perceive malaria as an ordinary or unavoidable illness rather than a preventable disease. Where the perceived seriousness of mosquito-borne diseases is low, households may be less motivated to practise preventive measures consistently.

There is also concern about inconsistent environmental prevention practices. Mosquitoes require suitable habitats for breeding, and household environments can provide numerous breeding sites through stagnant water, uncovered containers, discarded tyres, poor drainage and accumulated refuse. If households lack adequate knowledge or do not consider environmental management important, such conditions may persist and increase mosquito exposure.

The problem is further complicated by socioeconomic circumstances. The ability of households to obtain and maintain mosquito nets, use repellents, improve housing, install screens and seek prompt healthcare may be influenced by income and access to services. Consequently, failure to adopt recommended practices should not automatically be interpreted as unwillingness; it may also reflect structural and economic barriers.

Research conducted in different Nigerian settings demonstrates that knowledge, attitudes and practices vary across communities. In Oyo State, most respondents recognised mosquitoes as the cause of malaria, but ITN use remained low, while environmental hygiene was associated with malaria occurrence (Adebayo et al., 2010). In Lagos, educational level and housing type influenced some malaria-control attitudes and practices (Akinleye et al., 2021). These findings suggest that local context matters and that interventions should be informed by community-specific evidence.

The selected communities of Bassa, Ankpa, Dekina, Ofu and Ibaji present an important setting for such investigation. Despite the importance of malaria and other mosquito-borne diseases in Nigeria, there is limited integrated evidence documenting what households in these selected communities know about mosquito-borne disease prevention, how they perceive the diseases and what they actually do to prevent them.

The lack of community-specific KAP information presents a practical problem for public health planning. Without knowing whether residents lack information, hold misconceptions, have negative attitudes or face practical barriers to adopting preventive measures, health education and vector-control programmes may not adequately address the causes of low utilisation.

Furthermore, a uniform intervention across all five locations may not be appropriate. Bassa, Ankpa, Dekina, Ofu and Ibaji may differ in environmental conditions, socioeconomic characteristics, educational levels, access to health facilities and exposure to mosquitoes. A KAP assessment can reveal these differences and provide a basis for designing more locally appropriate interventions.

Another concern is that households may rely on prevention methods that are not necessarily sufficient or recommended as stand-alone measures. For example, some households may depend heavily on aerosol insecticides, traditional remedies, herbs, burning substances or other locally accepted methods while underutilising ITNs or environmental sanitation. Identifying the actual combination of practices is important for determining where health education should focus.

The problem also extends to treatment-seeking behaviour. Because malaria symptoms can overlap with other febrile illnesses, households that rely on self-medication or delayed treatment may experience avoidable complications. Evidence from Nigerian communities has shown substantial reliance on home treatment and medicine vendors for suspected malaria, emphasising the importance of appropriate health information and timely care-seeking (Adebayo et al., 2010).

The consequences of inadequate prevention can extend beyond individual illness. Recurrent malaria and other mosquito-borne diseases may contribute to absenteeism from school and work, household expenditure on treatment, reduced productivity and increased demand for health services. Vulnerable populations, particularly young children and pregnant women, may face greater consequences from malaria infection.

There is therefore a need to understand the behavioural context within which mosquito-borne disease prevention occurs. It is insufficient to know that preventive interventions exist; it is necessary to determine whether households understand them, accept them and use them appropriately.

The central problem addressed by this study is that mosquito-borne diseases remain an important community health concern, while current evidence on household knowledge, attitudes and practices concerning their prevention in selected communities of Bassa, Ankpa, Dekina, Ofu and Ibaji is inadequate. This evidence gap may limit the ability of health authorities and community stakeholders to develop targeted interventions that address specific knowledge deficiencies, negative attitudes and inappropriate practices.

Therefore, this study seeks to assess community knowledge, attitudes and practices regarding mosquito-borne disease prevention among households in selected communities in Bassa, Ankpa, Dekina, Ofu and Ibaji. The study will provide empirical evidence that can support health education, community mobilisation, vector-control programming and household-level preventive interventions.

1.3 Purpose of the Study

The main purpose of this study is to assess community knowledge, attitudes and practices regarding mosquito-borne disease prevention among households in selected communities in Bassa, Ankpa, Dekina, Ofu and Ibaji.

Specifically, the study seeks to:

1. assess the level of knowledge of mosquito-borne diseases among households in the selected communities;
2. determine residents’ knowledge of mosquito transmission, symptoms, risk factors and prevention;
3. assess the attitudes of household members towards mosquito-borne disease prevention;
4. identify the mosquito-borne disease prevention practices commonly adopted by households;.

1.4 Research Questions

The following research questions will guide the study:

1. What is the level of knowledge of mosquito-borne diseases among households in the selected communities?
2. What do households know about mosquito transmission, symptoms, risk factors and prevention?
3. What are the attitudes of household members towards mosquito-borne disease prevention?
4. What mosquito-borne disease prevention practices are commonly adopted by households?

1.5 Research Hypothesis

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

H₀: There is no significant relationship between household knowledge of mosquito-borne disease prevention and the adoption of preventive practices in the selected communities of Bassa, Ankpa, Dekina, Ofu and Ibaji.

1.6 Significance of the Study

The study will be significant to the following groups:

1.6.1 Kogi State Ministry of Health

The findings will provide the Kogi State Ministry of Health with community-level evidence concerning knowledge, attitudes and practices relating to mosquito-borne disease prevention. Such information can assist in strengthening malaria-control and health-promotion programmes.

1.6.2 Local Government Health Authorities

The study will be useful to health authorities in Bassa, Ankpa, Dekina, Ofu and Ibaji because it will identify specific behavioural gaps that may require intervention. The findings may guide community health education, household mobilisation and vector-control activities.

1.6.3 Community Health Workers

Community health workers may use the findings to identify common misconceptions and inappropriate preventive practices. This can help them develop more targeted health education messages for households.

1.6.4 Households and Community Members

The study may increase household awareness of the importance of mosquito-borne disease prevention. It may encourage residents to use ITNs consistently, eliminate mosquito breeding sites, maintain environmental sanitation and seek appropriate care promptly when illness occurs.

1.6.5 Community Leaders

Traditional rulers, religious leaders, youth organisations, women’s groups and other community stakeholders may benefit from the findings. They can use the evidence to support community mobilisation and collective environmental health activities.

1.6.6 Public Health Educators

The study will help public health educators design messages that address actual community beliefs and behaviours rather than relying exclusively on general malaria-control messages. This is important because research shows that knowledge does not always translate into practice (Adedotun et al., 2010).

1.6.7 Policymakers

The findings may support evidence-based policy decisions regarding malaria prevention, community mobilisation, distribution of preventive commodities and health education. The WHO’s emphasis on integrated vector control and community engagement further supports the importance of local evidence in designing vector-control programmes (WHO, 2017).

1.6.8 Researchers and Students

The study will add to the body of Nigerian literature on mosquito-borne disease prevention and KAP. It may serve as a reference for future studies involving malaria prevention, community health, environmental health and behavioural change.

1.7 Scope of the Study

The study will focus on the assessment of community knowledge, attitudes and practices regarding mosquito-borne disease prevention among households in selected communities in Bassa, Ankpa, Dekina, Ofu and Ibaji.

The content scope will include:

• knowledge of mosquito-borne diseases;
• knowledge of mosquito transmission;
• recognition of signs and symptoms of malaria and other relevant mosquito-borne diseases;
• knowledge of mosquito breeding sites;
• attitudes towards mosquito-borne diseases;
• perceived seriousness and susceptibility to mosquito-borne diseases;
• attitudes towards insecticide-treated nets;
• attitudes towards environmental sanitation;
• household use of mosquito-control measures;
• ITN ownership and utilisation;
• use of mosquito repellents and insecticides;
• environmental sanitation practices;
• elimination of stagnant water;
• household water-storage practices;
• healthcare-seeking practices for suspected malaria; and
• barriers to effective mosquito-borne disease prevention.

The geographical scope will cover selected communities within the five specified areas of Kogi State: Bassa, Ankpa, Dekina, Ofu and Ibaji.

The study will focus primarily on household-level KAP and will not constitute a clinical trial. It will also not attempt to determine the laboratory-confirmed prevalence of malaria unless laboratory testing is specifically incorporated into the methodology.

1.8 Operational Definition of Terms

Attitude: The beliefs, perceptions, feelings and dispositions held by household members towards mosquito-borne diseases and their prevention.

Community: A group of people living within a defined geographical area and sharing common environmental, social or administrative characteristics.

Community Knowledge: The collective level of understanding among residents concerning mosquito-borne diseases, their transmission, symptoms, risk factors and prevention.

Household: A person or group of persons living together and sharing arrangements for food and other basic domestic needs, as defined for the purpose of the study.

Insecticide-Treated Net (ITN): A mosquito net treated with insecticide to protect individuals from mosquito bites, particularly while sleeping.

Malaria: A potentially life-threatening disease caused by Plasmodium parasites and transmitted mainly through the bites of infected female Anopheles mosquitoes.

Mosquito-Borne Disease: A disease transmitted to humans through the bite of infected mosquitoes, including malaria and other diseases caused by mosquito-transmitted pathogens.

Mosquito Prevention Practices: Actions taken by households or communities to reduce mosquito breeding, prevent mosquito bites and reduce the risk of mosquito-borne disease transmission.

Knowledge: Information and understanding possessed by household members concerning mosquito-borne diseases, including their causes, transmission, symptoms, prevention and treatment.

Practice: The actual behaviours and actions undertaken by households to prevent mosquito-borne diseases.

Prevention: Measures undertaken to reduce the likelihood of mosquito bites, mosquito breeding and transmission of mosquito-borne diseases.

Vector: A living organism, particularly a mosquito in this study, capable of transmitting an infectious pathogen between humans or from an animal to a human.

Vector Control: Measures designed to reduce or interrupt the transmission of diseases by controlling mosquito populations or reducing human exposure to mosquitoes.

Project – Assessment of Community Knowledge, Attitudes and Practices Regarding Mosquito-Borne Disease Prevention among Households in Selected Communities in Bassa, Ankpa, Dekina, Ofu and Ibaji