title: Knowledge of human social and behavioral factors essential for the success of community malaria control intervention programs: The case of Lomahasha in Swaziland.
abstract: BACKGROUND
  Although malaria control programs have made rapid progress recently, they neglect important social and behavioral factors associated with the disease. Social, political, and cultural factors are involved in malaria control, and individuals in a community may be comfortable in behaving in ways that, to an outsider, may seem contrary to commonly held perceptions. Malaria control efforts can no longer afford to overlook the multidimensional human contexts that create and support varying notions of malaria and its prevention, treatment, and control. This study aimed to assess the knowledge and perceptions of malaria issues in the community, and to identify practices that support or hinder the progress of malaria control programs.
  
  
  METHODS
  A triangulation study involving individual interviews, focus group discussions, and observatory analysis between 2003 and 2010 at Lomahasha, a malarious community on the eastern border of Swaziland and Mozambique, was conducted.
  
  
  RESULTS
  Results indicated that a high knowledge level and good perception of the disease were observed in the age group of < 40 years, contrary to those in higher age groups, among the Lomahasha community members. However, behavior of certain community groups includes practices that are not supportive of the national control program's aspirations, such as delay in seeking medical attention, staying outdoors until late, maintaining stagnant water in roadside excavations, and seeking medical assistance from wrong sources. Malpractices are more commonly observed among men, boys, and those who drink alcohol.
  
  
  CONCLUSIONS
  This study suggests a thorough community diagnosis before all intervention programs for malaria control are instituted.
authors.affiliation: Department of Environmental Health, University of Swaziland, Mbabane, Swaziland.
authors.forename: Sabelo V
authors.initials: SV
authors.lastname: Dlamini
authors.affiliation: Department of Molecular Parasitology and Tropical Diseases, School of Medicine, Taipei Medical University, Taipei, Taiwan; Center for International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chien-Wei
authors.initials: CW
authors.lastname: Liao
authors.affiliation: National Malaria Control Programme, Swaziland Ministry of Health, Swaziland.
authors.forename: Zandile H
authors.initials: ZH
authors.lastname: Dlamini
authors.affiliation: Department of Community Health, University of Swaziland, Mbabane, Swaziland.
authors.forename: Jameson S
authors.initials: JS
authors.lastname: Siphepho
authors.affiliation: Department of Molecular Parasitology and Tropical Diseases, School of Medicine, Taipei Medical University, Taipei, Taiwan; Center for International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Po-Ching
authors.initials: PC
authors.lastname: Cheng
authors.affiliation: Department of Molecular Parasitology and Tropical Diseases, School of Medicine, Taipei Medical University, Taipei, Taiwan; Center for International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ting-Wu
authors.initials: TW
authors.lastname: Chuang
authors.affiliation: Department of Molecular Parasitology and Tropical Diseases, School of Medicine, Taipei Medical University, Taipei, Taiwan; Center for International Tropical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Global Health and Development Program, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan. Electronic address: tedfan@tmu.edu.tw.
authors.forename: Chia-Kwung
authors.initials: CK
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D000328:Adult; D019353:Endemic Diseases; D013541:Eswatini; D005260:Female; D017144:Focus Groups; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007407:Interviews as Topic; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods; D057147:Mosquito Nets; D009073:Mozambique; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Swaziland; community malaria control; intervention programs; social and behavioral factors