The influence of the Gilgel-Gibe hydroelectric dam in Ethiopia on caregivers' knowledge, perceptions and health-seeking behaviour towards childhood malaria.
BACKGROUND
Malaria remains the most important public health problem in tropical and subtropical areas. Mothers' or caregivers' ability to recognize childhood malaria-related morbidity is crucial as knowledge, attitudes and health seeking behavior of caregivers towards childhood malaria could influence response to signs of the disease.


METHODS
A total of 1,003 caregivers in 'at-risk' villages in close proximity to the Gilgel-Gibe hydroelectric dam in south-western Ethiopia, and 953 caregivers in 'control' villages further away from the dam were surveyed using structured questionnaires to assess their knowledge, perceptions and health seeking behaviour about childhood malaria.


RESULTS
Malaria (busa) was ranked as the most serious health problem. Caregivers perceived childhood malaria as a preventable ('at-risk' 96%, 'control' 86%) and treatable ('at-risk' 98% and 'control' 96%) disease. Most caregivers correctly associated the typical clinical manifestations with malaria attacks. The use of insecticide-treated nets (ITNs) was mentioned as a personal protective measure, whereas the role of indoor residual spraying (IRS) in malaria prevention and control was under-recognized. Most of the caregivers would prefer to seek treatment in health-care services in the event of malaria and reported the use of recommended anti-malarials.


CONCLUSIONS
Health education to improve knowledge, perceptions and health-seeking behaviour related to malaria is equally important for caregivers in 'at risk' villages and caregivers in 'control' villages as minimal differences seen between both groups. Concluding, there may be a need of more than one generation after the introduction of the dam before differences can be noticed. Secondly, differences in prevalence between 'control' and 'at-risk' villages may not be sufficient to influence knowledge and behaviour.
Department of Biology, Jimma University, Jimma, Ethiopia.
Delenasaw
D
Yewhalaw
Wondwossen
W
Kassahun
Kifle
K
Woldemichael
Kora
K
Tushune
Morankar
M
Sudaker
Daniel
D
Kaba
Luc
L
Duchateau
Wim
W
Van Bortel
Niko
N
Speybroeck
D000328:Adult; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission*; D008297:Male; D009035:Mothers; D010465:Perception; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014881:Water Supply