title: Malaria-related knowledge and prevention practices in four neighbourhoods in and around Mumbai, India: a cross-sectional study.
abstract: BACKGROUND
  India accounts for the highest number of malaria cases outside of Africa. Eighty per cent of India's population lives in malaria-risk areas, with cases increasing in urban areas. Mumbai, India, one of the most populous cities in the world, has experienced such an increase. To be successful, many malaria control efforts require community participation, which in turn depends on individuals' knowledge and awareness of the disease. This study assessed the knowledge and prevention practices regarding malaria in residents of four different areas of Mumbai, India, around the time of a malaria outbreak and the start of a widespread awareness campaign.
  
  
  METHODS
  A cross-sectional comparative study assessed malaria-related knowledge and prevention practices in four geographically and socio-demographically distinct areas of Mumbai, India. A structured interviewer-administered questionnaire was administered to a stratified random sample of 119 households between 16 December 2010 and 30 January 2011. Participant socio-demographic characteristics, malaria knowledge, malaria prevention practices, and household environmental factors were examined overall and compared across the four areas of Mumbai.
  
  
  RESULTS
  Overall, respondents had excellent knowledge of the mosquito as the means of transmission of malaria, mosquito biting times and breeding sites, and fever as a symptom of malaria. However, many respondents also held misconceptions about malaria transmission and symptoms. Respondents generally knew that bed nets are an effective prevention strategy, but only 30% used them, and only 4% used insecticide-treated bed nets. Knowledge and prevention practices varied across the four areas of Mumbai.
  
  
  CONCLUSIONS
  Although most residents know that bed nets are effective in preventing malaria, usage of bed nets is very low, and almost no residents use insecticide-treated bed nets. As the four areas of Mumbai differed in knowledge, prevention practices, and primary sources of information, malaria control campaigns should be tailored according to the knowledge gaps, practices, environments, resources, and preferences in different areas of the city, using the interpersonal and media channels most likely to reach the target audiences. Malaria control efforts involving bed nets should emphasize use of insecticide-treated bed nets.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Dhawan
authors.forename: Nidhin
authors.initials: N
authors.lastname: Joseph
authors.forename: Penelope S
authors.initials: PS
authors.lastname: Pekow
authors.forename: Christine A
authors.initials: CA
authors.lastname: Rogers
authors.forename: Krishna C
authors.initials: KC
authors.lastname: Poudel
authors.affiliation: Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts-Amherst, 715 N, Pleasant St, 01003 Amherst, MA, USA. bulzacchelli@schoolph.umass.edu.
authors.forename: Maria T
authors.initials: MT
authors.lastname: Bulzacchelli
mesh_terms: D000328:Adult; D000818:Animals; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D057148:Insecticide-Treated Bednets; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control; D011795:Surveys and Questionnaires; D055815:Young Adult
references.citation: Indian J Pediatr. 2011 Dec;78(12):1527-35
references.pmid: 21909781
references.citation: Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):69-78
references.pmid: 18165477
references.citation: Acta Trop. 2012 Mar;121(3):246-55
references.pmid: 22248528
references.citation: Lancet. 2010 Nov 20;376(9754):1768-74
references.pmid: 20970179
references.citation: Indian J Med Res. 1996 Jan;103:26-45
references.pmid: 8926025
references.citation: Indian J Med Res. 2012 Dec;136(6):907-25
references.pmid: 23391787
references.citation: J Vector Borne Dis. 2007 Sep;44(3):189-97
references.pmid: 17896621
references.citation: Lancet. 2011 Mar 19;377(9770):991; author reply 994-5
references.pmid: 21420545
references.citation: Lancet. 2011 Mar 19;377(9770):992-3; author reply 994-5
references.pmid: 21420547
references.citation: J Health Popul Nutr. 2012 Mar;30(1):113-6
references.pmid: 22524128
references.citation: Trop Doct. 2007 Apr;37(2):126-7
references.pmid: 17540112
references.citation: Am J Trop Med Hyg. 2010 Jun;82(6):1010-6
references.pmid: 20519593
references.citation: Trop Med Int Health. 1997 May;2(5):488-99
references.pmid: 9217705
references.citation: J Biosci. 2008 Nov;33(4):583-92
references.pmid: 19208983
references.citation: Lancet. 2011 Mar 19;377(9770):991-2; author reply 994-5
references.pmid: 21420546
references.citation: Natl Med J India. 2011 Jan-Feb;24(1):4-7
references.pmid: 21608349